Patient Forms

Save Time At Your Appointment By Being Prepared

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Download and fill out the Patient Health History Form to speed up your appointment.

We understand that finding time for a dental appointment can be challenging, which is why we strive to make your visit as efficient and convenient as possible. To streamline your appointment and minimize wait times, we encourage you to download and fill out the necessary forms prior to your visit. By completing the forms in advance, you can help expedite the check-in process and ensure that your appointment proceeds smoothly.

NP health-history HIPAA Notice of Privacy Practices Dental Disclosure Statement

If you’re unable to open PDF files, you can get Adobe Reader® for free.

If you have any questions or need assistance with the forms, please don't hesitate to contact our office, and our friendly team will be happy to assist you.

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Pittsburg, KS

611 North Broadway Suite B, Pittsburg, KS 66762

Email: clothierdentalappts@gmail.com

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Office Hours

  • MON7:30 am - 2:30 pm
  • TUE7:30 am - 2:30 pm
  • WED7:30 am - 2:30 pm
  • THU7:30 am - 2:30 pm
  • FRI7:30 am - 12:30 pm
  • SATClosed
  • SUNClosed
(620) 231-4140