Patient Forms

For your convenience, our patient forms are available online below in PDF format. Please feel free to download and fill them out at your own leisure to bring with you on your first appointment.

Consent To Proceed Form
Dental Evaluation Form
Medical History Form
Notice of Privacy Signature
HIPAA Patient Privacy Practices

New Patient Online Offer
Free
Cosmetic Dental Consultation

&
Office Tour
Now Accepting New Patients
Thorough Patient Education on prevention and dental treatment
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Our Location
Canyon Echo Dental
4811 NW 1st Street
Suite #4
Lincoln, NE 68521
(402) 435-7700
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