William J. Twohig, DDS

Natural & Holistic Dentistry

New Patient Forms

Call Today:

(920) 867-3101

We ask that those requesting to become a new patient please contact us via the contact form found here, or by calling us directly so that we may gather a little bit more information about you and your dental needs. For those that have already contacted us and have your new patient appointment set up, below you will find the links to the forms that you need to fill out and send in to us before your appointment. Note that the Notice of Privacy Practices is for your records and does not need to be sent back to us. The Records Release Form is for your signed consent to obtain dental records and x-rays from your previous dentist. If you have any questions, feel free to give us a call.

*Please fill out all forms completely*

Submit New Patient Forms