Digital Patient Forms

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Health & Medical History

Medical conditions can affect your dental health. Thank you for sharing your medical and dental history. It helps us better serve you.

New Patient Information

We have several customized ways to communicate with our patients. We can email, text, and mail statements, treatment plans, etc. There are also several different ways we can send out appointment reminders. Please fill out our patient information form and let us know what works best for you.

Financial & Appointment Policy

We look forward to serving you and being your dental home! Please read over our financial and appointment policies, so you know what to expect when reserving time with Dr. Jarvis and our friendly team at Great Northern Dental Care.

Policies, HIPAA, & Privacy Disclosure

Please read over our policies, privacy disclosure and HIPPA information so you know about our appointment and financial policies. In addition, your privacy is important to us. Let us know if there are any friends or family who might need to contact us about your dental care.

Records Release

For our comprehensive exam, we need two different x-rays. Bitewings detect cavities. This x-ray is usually recommended every year. A panoramic image gives us a big-picture view and is usually needed every 3-5 years. Let us know if you have one of these current x-rays from a previous office. We are happy to request them and any other relevant information on your behalf.

Parental Consent

You may not always be able to accompany your child to their dental appointment. Sometimes they drive themselves or a friend or family member brings them. This form allows us to treat your child when you’re not present.