Menu
  • Home
  • About Us
    • Meet the Doctors
      • Dr. James Theiss, DMD
    • Why Choose Us
    • Tour the Office
    • FAQ
  • Our Dental Services
    • General Dentistry
      • Dental Cleanings and Exams
      • Gum Disease Treatment
    • Cosmetic Dentistry
      • Dental Veneers
      • Teeth Whitening
      • Smile Makeover
    • Restorative Dentistry
      • Root Canals
      • Dental Crowns and Bridges
      • Dentures
      • Tooth Fillings
    • Dental Implants
    • Dental Emergencies
    • Relieving Dental Anxiety
    • Oral Surgery
      • Wisdom Teeth Removal
    • TMJ Treatment/Teeth Grinding
  • Patient Testimonials
  • Patient Resources
    • Patient Forms
    • Specials and Promotions
    • Payment Options
    • I’m Embarrassed to Smile
    • I’m in Pain or Have Discomfort
    • I’m Having a Hard Time Chewing
  • Blogs
  • Contact Us
  • Payment Plans
  • Contact Us
MENU
Contact Us
Call Today859-781-3090 Request An Appointment
2710 Alexandria Pike, Highland Heights, KY 41076
Call Today859-781-3090 Request An Appointment
2710 Alexandria Pike, Highland Heights, KY 41076
  • Home
  • About Us
    • Meet the Doctors
      • Dr. James Theiss, DMD
    • Why Choose Us
    • Tour the Office
    • FAQ
  • Our Dental Services
    • General Dentistry
      • Dental Cleanings and Exams
      • Gum Disease Treatment
    • Cosmetic Dentistry
      • Dental Veneers
      • Teeth Whitening
      • Smile Makeover
    • Restorative Dentistry
      • Root Canals
      • Dental Crowns and Bridges
      • Dentures
      • Tooth Fillings
    • Dental Implants
    • Dental Emergencies
    • Relieving Dental Anxiety
    • Oral Surgery
      • Wisdom Teeth Removal
    • TMJ Treatment/Teeth Grinding
  • Patient Testimonials
  • Patient Resources
    • Patient Forms
    • Specials and Promotions
    • Payment Options
    • I’m Embarrassed to Smile
    • I’m in Pain or Have Discomfort
    • I’m Having a Hard Time Chewing
  • Blogs
  • Contact Us
  • Payment Plans
Patient Forms
  • Save time by bringing forms to your first visit
  • Make appointments as early as 8 a.m.
  • Find our office near Northern Kentucky University

Schedule An Appointment With Your New Dental Team!

859-781-3090
Request An Appointment

We can see you as soon as tomorrow!

Home > Patient Forms

Bring Northern Kentucky Patient Forms to Your First Visit

Filling out paperwork is never an enjoyable task, but it’s even less so when you’re ready to meet your new dentist for the first time. At Northern Kentucky Dental Care, we want to get you in as soon as possible to see our Northern Kentucky dentist, so we’re offering you the option of printing out your new patient paperwork here and filling it out before your visit.
In the meantime, our friendly staff is happy to help you with questions regarding these forms, your payment options, or anything else. Just call us at 859-781-3090. We can’t wait to meet you! Our office is especially convenient if you live or work in ZIP code 41076.

  • Patient Forms
  • Acknowledgement of Receipt of Notice of Privacy Practices
  • Dental History
  • HIPAA Acknowledgement
  • Patient Financial Responsibility
  • Health History

API feed currently empty, remove module and inform the CSI or PM

Read Our Patient Testimonials
Rate Us
Call Today to Make an Appointment 859-781-3090 Request An Appointment
2710 Alexandria Pike, Highland Heights, KY 41076
  • Mon: 8am-5pm
  • Tue: 8am-5pm
  • Wed: 8am-5pm
  • Thu: 8am-5pm
  • Fri: Closed
  • Sat: Closed
  • Sun: Closed
859-781-3090 Request An Appointment

Locations

2710 Alexandria Pike, Highland Heights, KY 41076

Office Hours

  • Monday 8am-5pm
  • Tuesday 8am-5pm
  • Wednesday 8am-5pm
  • Thursday 8am-5pm
  • Friday Closed
  • Saturday Closed
  • Sunday Closed
859-781-3090 Request An Appointment

Locations

2710 Alexandria Pike, Highland Heights, KY 41076

Office Hours

  • Monday 8am-5pm
  • Tuesday 8am-5pm
  • Wednesday 8am-5pm
  • Thursday 8am-5pm
  • Friday Closed
  • Saturday Closed
  • Sunday Closed

Latest Blog Articles

The Advantages of Dental Implants Over Dentures

When it comes to replacing missing teeth, two of the most common options are dental implants and dentures. While both ...

Read More
How to Handle a Dental Emergency?

Introduction Quick response is crucial during a dental emergency. Learn the steps to manage common dental ...

Read More
  • Home
  • About Us
  • Patient Testimonials
  • Contact Us
  • Blogs
  • Site Index

© 2025 Northern Kentucky Dental Care | All Rights Reserved |Privacy & ADA Accessibility Guide|Sitemap

*Results May Vary By Individuals