Patient Forms

Home Patients Patient Forms

Convenient Online Forms

Filling out your patient forms is quick and simple with our convenient online forms. Submit your forms in one of two ways. Do everything online by downloading any relevant forms, filling them in digitally, and sending them to us via email at If you would prefer to have a physical copy, download your forms, print them off, and bring them with you during your next visit.


We ask that all patients fill out these forms before their first visit. If you are an existing patient and recently experienced a life change such as a change of name or address, please fill out a new form and bring it with you to your next appointment.

Be confident in your oral health – call Mary Ellen Wynn, DDS
for a smile you can be proud of!

To learn more about our wide range of comprehensive dental options, call today to schedule
a consultation, or fill out our convenient online appointment request form!

Patient Testimonials

International College of Dentistry
Academy of General Dentistry
American College of Dentistry