Digital Patient Forms
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.
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.
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 comprenhive 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.
Insurance Information
Patients often ask if Great Northern Dental Care is “in network” or if we ”accept” a patient’s insurance. We accept all insurance and will electronically file claims for our patients. However, GNDC is not contracted or “in network” with any private insurance. GNDC is a Healthy Montana Kids provider. If your child has HMK, give us a call.