COVID-19 Patient Screening Form
HippaAcknowledgement Form.pdf
If you are a new patient to our office, the attached files contain our new patient forms that will need to be filled out when you arrive at our Livonia dental office. Printing them, filling them out and bringing them with you will allow us to attend to you more quickly than completing them on your arrival. Thank you and please call our office at (734)422-0800 should you have any questions at all.
Patient Registration Forms
Total Health Form
HIPAA Form
Financial Policy Form
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
Susan Thomas DDS
16372 Middlebelt Road
Livonia, MI 48154
Phone: (734) 422-0800
Email: drsusanthomasdds@gmail.com
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