3110 Craig Road | Eau Claire, WI 54701 | 715.552.7227

Dr. Brad Meer, Dr. Christine DeLanghe & Dr. Emily Hehli

New Patients

 

Welcome to our office!

 

For each new patient, please fill out, print and bring the following forms with you to your first appointment.

 

We can also mail forms to you if you'd prefer. Please call our office to make arrangements.

 

If you are unable to do so, please arrive 15 minutes prior to your appointment to fill out the necessary paperwork.

 

 

 

Forms

Patient Information Form

 

Dental History Form

 

Medical History Form

 

 

The following form is optional to print and is for your reference only.

 

Updated Notice of Privacy Practices

 

Updated Notice of Privacy Practices (en español)

 

 

Thank you. We look forward to meeting you and welcoming you into our dental family.

 

3110 Craig Road | Eau Claire, WI 54701 | 715.552.7227

3110 Craig Road | Eau Claire, WI 54701 | 715.552.7227

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3110 Craig Road

Eau Claire, WI 54701

(P) 715.552.7227

(F) 715.552.7225

Maple Ridge Dental is proud to serve the following areas around Eau Claire, WI:

Altoona, Eleva, Mondovi, Fall Creek, Osseo and more