An unfortunate part of healthcare in the 21st century, below you can find a complete list of all of our forms. If you are a new patient, check out our
, for a less daunting list and more on what you can expect at your first visit.
Request for records to be sent to Grand Dental
This form is intended to aid you in getting pertinent dental records from another dentist sent to Grand Dental.
Request for records from Grand Dental to another dentist
This form authorizes to send your dental records to another dental provider. Please note that all requested information is sent by mail, federal law stipulates that we cannot email records to other providers.
Implant patient referral
Use this form if you have an implant patient you would like to send our way.
Email use authorization
This form allows us to communicate via email. It is necessary if you would like to discuss your treatment or schedule appointments via email in the future.
New patient forms
These forms allow us to get to know you and your health. In addition, you will find the not-very-exciting, but still important information on how we protect the information that you share with us.
Consent to release information to a designated adult
This form allows you to designate another person with whom we can discuss your health information and dental treatment. This individual could be your spouse, a parent, or child.
1005 Grand Avenue, Suite 200
West Des Moines, Iowa 50265
Monday: 8:00 - 6:00
Tuesday: 8:00 - 6:00
Wednesday: 8:00 - 5:00
Thursday: 8:00 - 5:00
Friday: 8:00 - 2:00
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Iowa Dental Association
Academy of General Dentistry
Des Moines District Dental Society
American Dental Association
2019 Chad B. Stevenson D.D.S., P.C. DBA Grand Dental •
West Des Moines, Iowa
A. Stevenson D.D.S. •