Fargo Mon.- Wed. 8AM-5PM  Thurs. 7AM-4PM Fri. 8AM-4PM           Barnesville : Tues and Wed 8AM-5PM

© Copyright 2013-2017 Dahl & Mack Dental. All Rights Reserved.
Confidential Health Information Form

To keep your medical/dental records private and in compliance with HIPPA regulations, all patients are required to provide a HIPPA Release of Records form signed before we are able to discuss or release and of your medical history to anyone in your family or other medical provider. Please download, read and complete this form. Bring it to your next appointment and we will update our records.

Patient Records Release Form

Before we are able to discuss or release any of your medical/dental  history to anyone in your family or other medical provider we must have a signed Release of Records Authorization form completed. This form allows or prevents us from sharing any of your health or dental records with anyone unless specified on this document. Please download the form on the left, print, read, complete this form and bring it to your next appointment.

New Patient Dental History Form

If you are a new patient, click on the icon to the left to download and print this new patient dental history form. You can fill this out prior to your visit to save time in the waiting room, all patients are required to provide this information so that we have a complete history on file.

In order to help you we need information. Use these document downloads to gather your information so we are better prepared to help you when you arrive.

Helpful Information

Patient Resources

Helpful forms to enhance your visit

In an effort to make your experience with Dahl & Mack Dental enjoyable and convenient we have provided these resources to save you time. Simply click on any of the links below and download the form. We have updated these forms and you can now complete these forms directly from your computer and submit via email or print and bring the completed documents to our office during your next visit which will save you time when you arrive. Click on the desired PDF icon, save to your desktop, fill out the form and click "Submit", once you have completed them save them and can simply update any changes you may have in the future and resubmit them to us.

We hope you find these documents helpful. Thank you.