Patient Forms

Thank you for choosing Kewaskum Family Dentistry! Below you will find links to our online forms, or if you prefer, you can download them to print and fill out before you come in for your appointment.

Patient Forms

Thank you for choosing Kewaskum Family Dentistry! Below you will find links to our online forms, or if you prefer, you can download them to print and fill out before you come in for your appointment.

Patient Forms

Thank you for choosing Kewaskum Family Dentistry! Below you will find links to our online forms, or if you prefer, you can download them to print and fill out before you come in for your appointment.

New Patient Forms

Online Forms

New Patient Letter

Patient Info

Health History

Photographic Authorization & Release

TMJ Health Questionnaire

Myosleep Kids Questionnaire

COVID-19 Prescreening

PDF Forms

Receipt of Privacy Practices

Why Our Membership Plan Might Be Right For You

No dental insurance? Children and adults can still receive the same great dental care with our membership plan.

Yearly membership plan to cover routine cleanings and exams and even emergency visits
Save money and receive the dental care you deserve
Payment options available

Why Our Membership Plan Might Be Right For You

No dental insurance? Children and adults can still receive the same great dental care with our membership plan.

Yearly membership plan to cover routine cleanings and exams and even emergency visits
Save money and receive the dental care you deserve
Payment options available

Why Our Membership Plan Might Be Right For You

No dental insurance? Children and adults can still receive the same great dental care with our membership plan.

Yearly membership plan to cover routine cleanings and exams and even emergency visits
Save money and receive the dental care you deserve
Payment options available

Steve Davey

Dr Garrett was great, he put me at ease as soon as I entered the room, great sense of humor. Great new surgery, the staff are extremely polite and helpful. I would recommend Kewaskum Family Dentist to anyone.

Luanne Schulz

Wonderful experience getting a cleaning, crown and filling done. Beautiful new building, pleasant staff and dentists.

Gloria Ponczoch

The receptionist greeted me with a smile and very friendly attitude. The dental hygienist and dentist were very personable and friendly and very knowledgeable. It was a wonderful dental experience. 😍

Rick Mitchell

Excellent experience for the first time, the dental hygienist kari was very informative and did a great job.

rick carlson

Having dental work at kewaskum family dental is always fast, friendly, and courteous. And the staff isnt half bad either, lol- they are Great!

Mary Thiemer

Great, professional clinic. The staff is friendly and experienced. I couldn't ask for more

Laura Meyer

My husband saw Dr. Jones and everything went very well. He said he felt very relaxed in Dr. Jones care, and Dr. Jones did a very good job. The girls at the front desk are always smiling when you come in. It has only been his third time there and he has been very happy with all the care.

Melissa

If you’re looking for a new dentist, because your other dentist experiences left a lot to be desired like I was …… This is your place! Easy, painless, and comfortable experience. Dr. Garrett and eveyone is great!

Glen Moegenburg

Had a cap put on. I don’t even know it’s there, and that’s as good as it gets.

Mark Olson

Friendly, professional staff , pleasant experience. Thank you. 5 star service