Please take a minute to fill out the online form. If you would rather print the forms, just print out the forms and bring them with you to your dental appointment. You may also access our online patient registration by clicking the link below.
Online Patient Registration Form
Insurance Information & HIPAA AcknowledgementFinancial Understanding
Patient ReferralNotice of Privacy Practices HIPAA (this is for your information) No Show / Cancelation Policy (this is for your information)
Please note that x-rays will be taken on FIRST appointment unless you bring current x-rays with you or have them emailed to our office. They can be emailed to firstname.lastname@example.org OR email@example.com
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Outstanding services. I just cant say enough about this dental office, they go above and beyond to make your visit comfortable, pleasant,and professional. The entire staff is great.
Dr. Wenona was able to save a tooth that had a below gumline issue. She referred me to a periodontist then finished the final procedure herself. Prices are reasonable (I'm self-pay) and the staff is positive all the time.
Dr. Pat and Dr. Winona are very professional, thorough and trustworthy Dentists. I highly recommend this Dentist practice along with the Staff.
The Vanderhei’s and entire staff are fantastic. They take the worry out of dental visits and make the experience positive. Highly recommend.
VIP Family Dentistry is absolutely first rate! Best group I have ever had. Dr. Patrick is highly skilled and always puts me at ease . Jennifer has made my cleaning sessions easy . Beth and Heather and Brittany always greet me with a smile. Highly recommended.
The VIP team is simply amazing. They don't just care about your teeth, they care about YOU. In today's world, that kind of care is almost impossible to find anywhere. I adore this staff, and Dr.s Van der hi.
All I can say is if these folks are amazing. The office staff is very friendly and accommodating. Dr. Pat has gone above and beyond in treating me on several occasions.