Enrollment Forms

At Dr. Cade Hunzeker's Pediatric Dental office we strive to make your child's visit a pleasant and stress free appointment.  One important way to do this is allowing parents to fill out necessary paperwork in the convenience of their own home or office and either securely emailing them or printing them and bringing the forms with you to your child’s visit.  Allowing Mom and Dad to relax at our office will pass that same relaxed attitude on to your children. Please take the time to consider one of our two ways to complete these forms below.

Pick the method that works for you. 

1) A complete online sign-up. This is an online form (HTML) allowing you to enter all the necessary information before we see your child. This form is sent electronically and direct to our office. All personal information is encrypted ensuring it is secure. 

2) This second option is a PDF Form allowing for you to enter all the necessary information online and then print the 2 page form and bring with you to our office. 

  • New Patient Enrollment (Input Data and Printable Version)
    If you still prefer the pen and paper method, you can print this form and complete. We are also happy to continue to provide a blank form at the time of your visit.

 

 Other helpful Forms





Bring the Family

 Enroll

CAVITY FIGHTER

 CHOPS

CHOPS is Dr. Cade's Mascot for fighting cavities. Be sure to keep an eye out for games and quizzes coming soon to our site.