Patient Forms

Before your family's first visit to Dr. Mondock, let's get some basic paperwork out of the way.

Patient Information Form

First Appointment Form

Please COMPLETE and then PRINT the First Appointment Form, then bring a copy with you to your appointment. Please DO NOT EMAIL the completed form, as it contains sensitive personal information.

If you have any questions or concerns, please don't hesitate to contact us today.

Financial Information

If you are self-pay or have dental insurance that has a deductible, copays, and/or frequency limitations, payment is due at the time services are rendered.

We accept cash, check, Visa, MasterCard, and CareCredit.

Download Dental Patient Form

Make Appointment wtih Dr. Mondock

Appointment Hours:


12:00 PM to 7:00 PM


8:00 AM to 5:00 PM


7:00 AM to 1:00 PM


9:00 AM to 6:00 PM

Closed on Friday

Closed on Saturday

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