Patient Forms

New Patients, Welcome!

Please fill out the following forms and bring them with you on your first appointment.

Patient Registration Form



Other Documents

Please see the documents below for extra information about our practice and our policies.

Financial Responsibility Form

Privacy Policy Form

Anti-Discrimination Policy

Check out our Specials!

Make sure to ask about our specials at your next appointment!

Click here for more specials

Office Policies

Kindly give us 24 hours notice if you can not make your appointment. Payment and or co-pays are due at the time services are rendered. We offer Care Credit, a credit card financing company. Ask for details-It’s a great way to achieve your optimal dental health!

Contact Us

25 E. Central Avenue
Springboro, OH 45066

P- 937-748-2220
clearcreekdentalassociates@gmail.com