Forms / Downloads

Online Forms

If you need to make a payment. Please select your payment option and click "Buy Now". 

Cash Payment Price





We are now serving patients in Indiana. You can find the necessary PDF forms at the links below. 

Consent Form - Indiana
Consent Form - Indiana (Spanish)
Whats Your Cost - Indiana
Whats Your Cost - Indiana (Spanish)



  • Excellent job! Excellent service! We have been very happy with the level of professionalism displayed by the staff and the care given to all our students. I've used other mobile dentists in the past and you have been the easiest to work with.

    - Tracy Hulsey
    RN Rome