Patient Forms

New patient? Please download and fill out the following forms when you come in for your first appointment.

Patient Medical History Form/Privacy Notice

These forms are mandatory for all new patients. To expedite your visit, print these forms and fill them out at home.  Please bring all four (4) them with you to your first visit..

Medical History Forms (3)

Medical History 1..pdf
.pdf File [449.8 KB]
Medical History 2..pdf
.pdf File [461.9 KB]
Medical History 3..pdf
.pdf File [513.5 KB]

 

 

Privacy Notice (HIPPA)

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.

Privacy Notice
HIPAA.2015 (1)..docx
.docx File [9.8 KB]

Make an Appointment Today!

Call us at: 810. 631. 4573

 

Hilltop Dentists, P.C.

12265 North State Road

Otisville, MI  48463

Fax: 810. 631. 9600

Email: hilltopdentists@yahoo.com

24 hour Emergency Contact 

24 hour emergencey contact info is as follows: 

James J. Fehrman, D.D.S.   810. 577. 9673

James H. Ford, D.M.D.      810. 931. 5973

Keep Your Teeth Healthy!

Preventive care is the best way to keep your teeth healthy.  Brushing for two minutes twice a day and flossing will make your next dental visit easier and more pleasant.  

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Hilltop Dentists, P.C.