New Patients - Bliss Dental Care

You will find all necessary paperwork needed for your first appointment available here. Please print these forms and complete them prior to your appointment.

If you have dental insurance, please bring a copy of your claim form and ID card or insurance booklet. We are always happy to help you with your insurance.

Everyone at Bliss Dental Care is happy to have you as a new patient and look forward to meeting you at your scheduled appointment!

Forms:

CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION
NOTICE OF PRIVACY PRACTICES
PATIENT REGISTRATION

Contact us to schedule an appointment by calling 952-447-3777 or by completing the form below.

First Name*

Last Name*

Address (line 1)

Address (line 2)

City

State

ZIP or Postal Code

Phone*

E-mail*

Please add your comments or questions:

* Required field