Patient Forms & Financial Information

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Patient Forms & Financial Information

Patients Form

•  New Patient Form: Adult•  New Patient Form: Child•  Patient Consent Form•  Patient Care Plan: In-House Insurance•  Sedation Form•  Dental Implant Consent Form

Financial Information

•  Financial Guidelines•  Patient Care Plan•  CareCredit•  Sunbit Payment Plans
Newark Smiles

Newark Smiles’ mission is to provide the very best care during each visit. Our gentle and compassionate staff employ methods that create a relaxing and comfortable dental experience with results worth smiling about.

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Contact

Address
1619 W. Main Street, Newark, OH 43055
Phone
(740) 522-1133
Fax
(740) 522-1178
Email
drshah@newarksmiles.com
Monday:        8am to 5pm
Tuesday:        7am to 4pm
Wednesday:  8am to 5pm
Thursday:      8am to 5pm
Friday:            8am to 2pm
Saturday:       Closed
‍Sunday:           Closed
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