New Patient or New Insurance?

     If you are a new patient or an existing patient who would like to update your information, please fill out the appropriate forms and bring them with you.

     The forms are fillable PDFs so you can either enter your information on the computer and then print or you can print first and fill them out by hand.

     This will allow us to tend to your dental needs faster than completing them upon your arrival.

     Thank you and please contact us if you have any questions.

New Patient Forms

• Adult Form (14+)

• Child Form (2-14)

• Patient Financial Policy

  
  

Current Patient Form

• Patient Information Update

• Post-op Care Instructions
  

• Consent to Communicate

Need More Information?

If you would like to schedule an appointment, please call us at 402-571-3415 or submit an online request here.

For a list of procedures we perform at Ohana Smiles, please check out the procedures page.

For a map, driving directions, or to send us a note, please check out the contact us page.

Cannot wait to meet our friendly staff?  Please check out the about us page.