Patient Forms

HIPAA FORM

PATIENT REGISTRATION FORM

YOUTH PATIENT REGISTRATION FORM - (Patients age 16 and under)

ADULT MEDICAL HISTORY - (Required for New Adult Patients)

ADULT DENTAL HISTORY - (Required for New Adult Patients)

GUIDELINES FOR PATIENT SEDATION

PATIENT AUTHORIZATION FORM

PATIENT PHOTO RELEASE FORM

PERMISSION FORM FOR WEBSITE COMMENTS

Let's plan your next visit with your Fargo Dentist

If you are looking for a dentist in Fargo to trust and care for your dental health, schedule your visit with us today. Learn who we are and make the commitment to take care of your dental health. You can reach us at (701) 356-1280.

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2585 23rd Ave. Suite C.
Fargo, ND 58103

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Family Dentistry Cosmetic Dentistry Dental Emergencies Dental Implants Dentures Teeth Whitening Veneers Invisalign TMJ

Fargo, North Dakota dentist, Mengedoth Dental is committed to dental excellence and offers patients a comprehensive list of family and cosmetic dental services including dental cleanings & exams, teeth whitening, tooth colored fillings, crowns, bridges, dentures, Invisalign, emergency dental care, and more. Please come and visit Fargo, ND dentist, Dan Mengedoth DDS.

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