Patient Forms
HIPAA Privacy Practice and Patient Forms
For over 25 years, Soder Dentistry has been serving Indianapolis, IN with quality dentistry service. You've played a critical part in allowing us to provide great service, and we appreciate that. We hope to continue to do so in the years to come.
Help Us Serve You Better
Please download and fill out the Patient Registration Form / Medical and Dental Form and the Financial Responsibilities Statement Form. Bring them along when you visit us. This will ensure that your visit proceeds without a hiccup.
Other things you need to carry
- Referral note and X-ray reports from your dentist and / or physician
- Dental insurance cards and / or claim forms with insurance address information
- A parent or legal guardian if you are under the age of 18
Please download and fill these forms
You can also read the Health Insurance Portability and Accountability Act (HIPAA) Form describing the privacy practices.
