"Great staff, great service! My kids look forward to going to see the dentist instead of being afraid! As parents, we look forward to going to FPD to see great people and wonderful friends. Proud to have FPD as our dentist."

Adelia B.

New Patient Forms

Online New Patient Form

So that your first visit can be more fun and less bogged down with paperwork, we've made our

New Patient Form available online by clicking HERE,

or you may print the PDF version to fill out and bring with you (links below in English or Spanish).  You may also download and print the other required forms, fill them out and bring them with you to your appointment.  It's that simple and you will be ready to go when you arrive! If you have any questions, don't hesitate to call.

Printable New Patient Forms

New Patient Form  (PDF) - English 

New Patient Form (PDF) - Spanish


HIPPA Receipt Form (PDF)

Financial and Appointment Policies (PDF)

Fluoride Varnish Consent (PDF)


© Fishers Pediatric Dentistry. All Rights Reserved
9126 Technology Lane, Suite 100
Fishers, IN 46038

Phone: 317-598-9898 | Fax: 317-596-9659
Located near I69 and 116th Street, behind Super Target.
Map and Directions  |  Hours  |  ( Freedom )