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Just A smile away dental
Home
About Us
  • Why Us?
  • Meet the Doctor
  • Our Location
  • Testimonials
  • FAQs
Services
  • Cosmetic Procedures
  • Teeth Whitening
  • Tooth Removal
  • Root Canals
  • Implants & Dentures
  • Crown & Bridge Work
  • Restorations & Fillings
  • Nonsurgical Gum Treatment
  • Same Day Denture Repairs
  • General Dental Procedures
  • My Forever Smile® Braces
For Patients
  • After Hours Care Info
  • Forms
  • Oral Hygiene
  • Financial/Insurance Info
  • In-House Dental Plan
  • Patient Payment Center
Contact Us
Latest News
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  • Home
  • About Us
    • Why Us?
    • Meet the Doctor
    • Our Location
    • Testimonials
    • FAQs
  • Services
    • Cosmetic Procedures
    • Teeth Whitening
    • Tooth Removal
    • Root Canals
    • Implants & Dentures
    • Crown & Bridge Work
    • Restorations & Fillings
    • Nonsurgical Gum Treatment
    • Same Day Denture Repairs
    • General Dental Procedures
    • My Forever Smile® Braces
  • For Patients
    • After Hours Care Info
    • Forms
    • Oral Hygiene
    • Financial/Insurance Info
    • In-House Dental Plan
    • Patient Payment Center
  • Contact Us
  • Latest News
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  • Home
  • About Us
    • Why Us?
    • Meet the Doctor
    • Our Location
    • Testimonials
    • FAQs
  • Services
    • Cosmetic Procedures
    • Teeth Whitening
    • Tooth Removal
    • Root Canals
    • Implants & Dentures
    • Crown & Bridge Work
    • Restorations & Fillings
    • Nonsurgical Gum Treatment
    • Same Day Denture Repairs
    • General Dental Procedures
    • My Forever Smile® Braces
  • For Patients
    • After Hours Care Info
    • Forms
    • Oral Hygiene
    • Financial/Insurance Info
    • In-House Dental Plan
    • Patient Payment Center
  • Contact Us
  • Latest News

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  • Bookings
  • My Account
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  • Bookings
  • My Account

Forms

Now, you can complete all required forms before your first visit through our secure and convenient online portal. Our forms are easy to fill out from your home computer or smartphone. If you choose to complete forms in our office, you’ll need to spend some extra time with us and arrive 15 minutes prior to your appointment.


The first button below links to the following forms:


  • Adult Registration
  • Child Registration
  • HIPAA Acknowledgement
  • HIPAA Notice Form
  • Insurance Authorization Form
  • Medical History

All FormsFinancial & Insurance InfoOral Hygiene

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Just A Smile Away Dental

3456 Shattuck Road, Saginaw, MI, USA

19897928315

Copyright © 2026 JUST A SMILE AWAY DENTAL - All Rights Reserved.

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