Challgren Dentistry

New Patient Forms

Save time waiting in our office by filling out your new patient form before your first visit. Download a printable PDF form by clicking on the links below.  Adult forms are for individuals 13 and over. Child forms are for those 12 and under. Feel free to give us a call if you have any questions.

Our HIPAA privacy policy is also available for you to review.

If you have difficulty using our website, please email us or call us at (765) 446-9606
View the ADA Accessibility Statement
Our office has implemented several new procedures in order to provide a safe environment for our patients and staff during the COVID-19 pandemic.  Our waiting room will remain closed for the foreseeable future.  When you arrive at the front door, a staff member will greet you to ask you a few screening questions and take your temperature.  Social distancing measures will be taken and treatment rooms will be isolated.  We have implemented many new cleaning and disinfecting measures.  Air purifiers have been installed in each procedure room.  Please know that we are continually monitoring the pandemic and are dedicated to keeping our patients and staff as safe as possible. We appreciate your patience and understanding during this time.