• Dental Associates of Decorah, PC Dental Associates of Decorah, PC
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Patient Forms

Please print out the form below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon.

  • Health History Child (ages 13 & under)
  • Health History Adult  (above 14 years of age)
  • Health Information Verbal Communications Authorization
  • Financial Policy
  • Notice of Privacy Practices
  • Privacy Notice
  • Insurance Signature Form

Please download Adobe Acrobat below to view/print forms:


Dental Associates of Decorah, P.C.
501 Sanford Street Decorah, IA 52101
Phone: 563-382-2441
Fax: 563-382-6048
Email: questions@dentalassociatesdecorah.com
www.dentalassociatesdecorah.com

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