Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out, and bringing them with you, will allow us to attend to your medical needs more quickly than completing them upon your arrival.  Thank you and please call our office if you have any questions.

We regret to inform you that due to HIPAA regulations these forms must be printed out and brought to us in person.  Thank you for your cooperation!


(Print & Complete All Forms Prior To First Office Visit)


ADA Patient Screening Form for COVID-19


 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.



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1410 E 85th StreetMerrillville, IN 46410Get Directions(219)736-2300
2024 Michael H. Min, D.D.S.  • 
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