Patient Forms

Important Forms for Patients

New Patient Forms

Click button below to fill out forms online prior to your appointment

Below are commonly requested patient forms. Click the link below to download and print off the forms. You can bring your completed forms directly to the office, mail them to the office address, email them to mankatofamilydental@gmail.com, or fax them to 507-345-4460. 

Please be aware that there is some level of risk that third parties may be able to read unencrypted electronic communication such as e-mail and fax.

Call Mankato Family Dental at (507) 345-4259 with any questions. We look forward to seeing you!

-Use or Disclosure of Patient Information - This consent allows you to designate a personal representative such as a family member or friend to inquire and receive information about your dental care as if they were you.

- Authorization for Release of Dental Records to Mankato Family Dental

- Patient Authorization for Release of Dental Records - If you have decided to leave our practice for whatever reason and would like your current dental records transferred to your new dental home please fill this out and return via the methods mentioned above.