Patient Forms

Welcome to Pike District Smiles

We provide a welcoming, relaxed setting for all your preventive, cosmetic and emergency dental care. We take the time to get to know your dental and medical history, understand your concerns and properly diagnose your needs. Your comfort is our priority as we build a relationship for a lifetime of smiles! New Patients we will cover you with our Patient Forms for dental care for all your dental problems.

New Patients Specials

Dentist showing dental results on X-rays to her patient at Pike District Smiles.

$99 New Patients Exam, X-ray & Cleaning

We make it easy for new patients with our $99 new patient package covering a comprehensive exam, all required x-rays and dental cleaning ($360 value). Plus $50 off your first treatment.

Free Teeth Whitening for Life

We offer patients free teeth whitening for life so you can keep smiling. After your first visit (exam, x-rays and cleaning), we provide you with professional teeth whitening take-home kits every 6 months after each checkup.

Your First Visit

We look forward to making your first visit an enjoyable experience from start to finish! Your first visit consists of an exam, discussion of treatment options and often we’ll start treatments the same day. For complex treatment plans or medical histories, it may require an evaluation and a follow-up visit for treatment.

What to bring to your first visit?

  • Dental insurance information
  • Previous dental x-rays
  • List of medications & medical conditions that may impact treatments

SCHEDULE FIRST VISIT

Enjoy our $99 new patient
exam, cleaning & x-rays

SCHEDULE FIRST VISIT

Enjoy our $99 new patient
exam, cleaning & x-rays

SCHEDULE FIRST VISIT

Enjoy our $99 new patient
exam, cleaning & x-rays

Our Patients Say

Ready to Smile? Visit Us Today