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Online Registration Forms

Call 918-542-2858
  • Miami ,OK - 1306 N. Main St 74354
  • Vinita ,Ok - 120-A West Delaware Ave. 74301
  • 918-542-2858 | Miami ,OK - 1306 N. Main St
  • 918-256-6831 | Vinita ,Ok - 120-A West Delaware Ave.

Patient Registration--using Dentrix or Truforms (subscription)

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.


We combine experience with the latest in dental technology to deliver the best patient experience possible.

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