We are very proud that you have chosen Cleveland Dental for your dental care.

In order to better serve you we have made your patient registration easy by allowing you to register prior to your appointment via the Internet or you may print out the three registration forms below and bring in at your appointment.

Register Online

Click here for online new patient registration!

Printable Forms

You will need ALL 3 forms completed for your initial visit. Having these forms filled out in advance of your appointment will save you time at your visit. To print the following forms, you will need Adobe Acrobat. If you do not have Acrobat you may download it free here:

You will need to fill out all the forms and bring to the office with you at your initial visit. Remember, having these forms filled out in advance of your appointment will save you time at your visit.

Patient Registration Form

Medical History Form

Informed Consent/Financial Policy Form

Financial Arrangements

Our office accepts the following payments:

Cash, Check, Debit cards, Visa, MasterCard, Discovery, & American Express

We also offer with prior approval:

  • In house short term credit agreements for patients with established payment history with our office.
  • Care Credit – with credit lines to fit your budget, from no interest to longer term low interest.