During you first visit to our office you will be asked to fill out a Patient Information Form.
For your convenience we have made this form available online. Fill this form out online at you convenience to save time at the office. And at any time you have changes to your original form feel free to make the appropriate changes online to keep your records up-to-date.
You have two options for filling out the form.
- Fill out the form online and it will be e-mailed to our office after you have completed the form and click on the "submit" button .
- Download the Adobe Acrobat version of the form, print it out on your local printer, fill it out and fax it to our office at the fax number listed below. You may also fill out the form and bring it in to the office on your first visit.
7835
Remington Road
Cincinnati, Ohio 45242
Phone:
513-793-1977
Fax: 513-793-1943
Reach
us via e-mail:
Alan R. Weinstein: arwdds@aol.com
Alex Della Bella: DellaBella@wdbDentalhealth.com
