Forms & Finance

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To reduce the amount of paperwork when you arrive for your visit, please complete our Patient Registration forms before arriving for your appointment and bring them with you. Whenever possible, we mail you these forms along with a detailed estimate prior to your surgery date so you can make appropriate financial arrangements before your visit. You may download and print copies of the Patient Registration Forms here on our website if you do not receive them by mail.

Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Registration


Dental Office Referral

Fill out and download the form below and send securely via email to or fax to 701.478.4407


For questions or assistance with referrals, please Contact Us


An estimated patient responsibility with be provided to you prior to surgery, we ask that you pay the estimated amount 10 days prior to surgery to secure your appointment. We do not offer financing through our office. However, we do accept Care Credit and Sunbit as outside financing options. For more information, the links for Care Credit and Sunbit are offered below.