Please do not fill out forms until you have an appointment set up. Forms filled out without an appointment are automatically deleted.
Thank you for choosing North Point Pediatric Dentistry. Please follow the link below to a secure portal to complete, review and sign all necessary documents. By law, we are required to have this information on file in order to treat your child/children. Please complete all necessary forms and consent documents in their entirety 2 to 7 days in advance of your appointment time.
All documentation must be completed by a parent or court appointed legal guardian, no exceptions. Failure to complete all necessary forms may require information to be completed once again, in office. If you have any questions, please contact our office and we will be happy to help you.
PLEASE NOTE: If you are not filing insurance with Indiana Medicaid, please leave the last form blank but sign where indicated. It will not be attached to your account but it is necessary to submit the package of forms electronically.