Patient Consent Forms

Most of the consent forms on this page are read-only. They will need to be signed and dated for the day of your procedure at the office. The Photo Release and Medical Records Release forms are the two exceptions that can be completed ahead of time if you choose to do so.

Feel free to contact us at (219) 836-4214 if you have any questions or concerns!

Request for Access to Medical/Dental Records

Photo and Video Testimonial Release Form

Consent for AI Transcription