Patient Forms

At the dental office of Waseca Dental Care, P.L.L.C., we offer patient forms online so that you can complete them in the convenience of your own home or office prior to you upcoming visit. Please submit them after completion. If you would rather print them and fill them out, you can bring the completed forms with you to your appointment or fax them to us beforehand at 507-835-1184.

Patient Forms

• Adult Registration
• Adult Medical History ages 12 and older
• Child Medical History ages 11 and younger
• Notice of Privacy Practices
• Consent to Release Health Information For Individual
• ARCI
• Consent to Release Family Health Information For 2 or More Patients