1011 E Prescott Rd
Salina, KS 67401
PATIENT RESOURCES
Patient Forms
For New Patients
If you are a new patient to our office, the link below contains our new patient bundle with forms that will need to be filled out prior to your upcoming appointment. For your convenience, we offer our patients multiple options for completing the New Patient Packet:
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Complete Online - You may complete your forms securely online by clicking "Complete Forms Online" below.
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Download and Print - You may download and print the New Patient Packet (see information below).
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Complete In-Office - You may complete the New Patient Packet in our office waiting room prior to your appointment. Please arrive at least 20 minutes to your appointment if you choose to complete your paperwork in office.
Please let us know if you have any questions about the new patient packet or your upcoming appointment.
Download and Print Forms
To download and print our New Patient Packet to be filled out by hand, you must download and print the forms by clicking "Download Forms" below.
The following forms are included in the New Patient Packet and must all be completed prior to your upcoming appointment:
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New Patient Form
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Health History
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Financial Agreement
DR. ROBERT MOELLER, DDS
Serving Kansas with Transformative Dentistry Since 2010
Dr. Moeller is the founder and owner of Great Plains Periodontics & Implant Dentistry. Under his expertise, patients enjoy honesty and integrity in practice, truly personalized care and exceptional clinical results.
