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Springfield Family Dental

Your first visit

First of all, thank you for choosing us to take care of your dental needs! Your first visit to the doctor typically includes an x-ray that allows the doctor to view the structure of the jaw, the position of any teeth that have not yet erupted, malformed roots, and tooth decay.The initial visit also involves getting your medical history. When you share your medical history with the doctor, be sure to provide complete, up-to-date information on your health. Inform your doctor if you have experienced recent hospitalization or surgery, or if you have recently been ill. Also tell the doctor the names, doses, and frequency of any medications you are taking — whether prescription or over-the-counter products — and the name of your physician. Inform the doctor of any changes in your health or medications. This information will help the doctor to select the most safe and effective method of treatment for you. 

Patient forms

Please help us be prepared for your appointment whether you're new to our practice or it's just been a while since we've seen you, by completing this Patient Information and Medical History form.  Download the form below to your computer, print it out, complete the form, and bring it with you to your first appointment. If you prefer to save a tree & not worry about leaving it on the kitchen counter, you can also email it to us and we'll have it ready & waiting for your signature at your next appointment! 

**The DOCX form is a MS Word document and will open as "read-only." To make changes to it, simply save it to your computer and once completed you can save and email or print it. 

Patient Health History Forms- read only (docx)Download
Patient Health History Forms (pdf)Download

Privacy policy

We take your privacy seriously. For all of you who enjoy reading legal jargon, then click to read our full policy. For those of you who have no interest, it's ok. Just know your info, history and email address are safe with us! Plus we will be happy to give you a copy when you visit the office.​ 

privacy policy (pdf)Download

Legal Stuff

For those of you who enjoy this type of "legalese"- read away! Otherwise, this is us being compliant & staying up to date on all that's important! 

OCR Notice of Nondiscrimination (pdf)

Download

Language Assistance (pdf)

Download

Springfield Family Dental

201 5th Ave. W., Springfield, TN 37172

(615) 384-2659

Copyright © 2023 Springfield Family Dental - All Rights Reserved.

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