New Patient Forms – Please Print and Complete Prior to Your Visit

To save you time you can download the four New Patient Forms by simply clicking on the links below. You can either just print them or save them to your computer and then print them. This will allow you time to fill them out carefully and completely in advance of your initial appointment with us and save you and us time at your visit. If time allows, mailing them to us before your appointment gives Dr. Langberg a chance to review your medical and dental history and gives Kelly time to verify insurance information so we can be much better prepared for your first visit. If there is not enough time for mailing them, simply bring the completed forms with you when you come to the office.

You need the Adobe Acrobat reader installed on your computer to open these forms. (If you do not have the Adobe Acrobat Reader installed, follow the link at the bottom of this page and then return to download the forms.)

You may either right-click. and use the Save Target As . . . option (recommended) or double-click the form to open it in your browser.

Please print the following forms and complete the required information prior to your first visit.

New Patient Forms:

Download All New Patient Forms in One Package


Snoring and Sleep Disorders Forms:

If you plan to or have scheduled an appointment for a Sleep Disorder such as Apnea or Snoring, please download and print the following forms and either mail them to us as soon as possible or bring them already filled out with you to your appointment:

Download All Sleep Disorder Forms in One Package

Download Adobe Reader


New Patients Are Always Welcome!

Many of our valued existing patients such as you refer their friends and family to our office because they appreciate the service they receive, feel understood, secure, well taken care of and they TRUST us.

That’s why
we want to say “thank you” for your kindness and confidence in us by giving you a $30 gift card of your choice
each time you refer a new patient to us.

In addition, each person you refer will also receive a $30 gift card!
Refer a handful of co-workers and pick up a stack of cards! What could be more fun?

We appreciate you being a part of our practice family!
Call us at
248-356-8790
for more info!
Thank you!