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 145 S Main St Ste 1, Wayland, MI 49348

If the appointment is for your child who is 2 years old or younger, please print and fill out this form instead of the new patient forms and bring it in person to the appointment. 

If you are a current patient who needs to make updates to personal information, medical history, or billing, please fill out the "returning patient" forms.

If the appointment is for a patient aged three or older, please fill out these forms.

Patient Forms

Please complete the forms below online. 
To comply with patient privacy standards, we cannot accept emailed forms.
Thank you for your understanding!

Please complete the forms below online. To comply with patient privacy standards, we cannot accept emailed forms. Thank you for your understanding!

New patient forms

Returning Patient Update Forms

1 & 2 Year Old New Patient Forms

Notice of
Privacy Practices

Please read and retain for your records.

145 S Main St Ste 1
Wayland, MI 49348
Home
Phone: 269-792-2220
Email: info@paulinglesdmd.com
269-792-2220
info@paulinglesdmd.com
Paul Ingles DMD
Copyright 2024 Paul Ingles DMD, PLLC.
All Rights Reserved.

Copyright 2024
Paul Ingles DMD, PLLC.
All Rights Reserved.

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