Patient Forms
Thank you for choosing Steiner, Rotenberg, & Lindsey LLC.
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Note to Patient: Upon filling out your first name, last name, email and at least one phone number field (a valid home or cell phone) a button will appear in the upper right corner titled “Save and Exit” . This button allows you to save and exit your form to complete at a later date. The system will send a registration email to the email provided on the form, so that you may setup a login to go back and finalize your registration form online.
New Patients
If you are a new patient, we recommend arriving a few minutes early to allow time for registration and completion of any necessary forms.
Please bring:
- A valid photo ID
- Your insurance card(s), if applicable
- A list of current medications
- Referral information from your dentist, if applicable
- Any recent dental x-rays or imaging that may assist with your evaluation
Questions?
If you have questions regarding patient forms or registration requirements, please contact our office at (614) 863-9500. We appreciate your patience as we update our online forms and look forward to serving you.