For your convenience, Dental Corner has provided our patient forms online. We encourage you to complete them prior to your appointment with Drs. Jay Hildreth, and Tommy Rose. If you have questions about our patient forms, and to make an appointment with our dentists in Wichita, Kansas, please call us at 316-681-2425.

Online
Financial Information

Medical History

Patient Information

Signed Acknowledgement

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Financial information

Medical history

Patient information

Signed acknowledgement