• bloomfielddentalcare@gmail.com
  • 248-338-3550
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New Patients



Welcome to our practice! We look forward to providing you and your family with dental care for many years to come. Please tell us a bit about your health by filling out this patient information form (using either the Word or PDF format). Feel free to either email it to us (bloomfielddentalcare@gmail.com) or bring a copy of it to your appointment. If you have any questions, please call 248.338.3550.

Patient Information Form in Word (.doc) format

Patient Information Form in PDF format