New Patients

Thank you for choosing Archbold Family Dental for your dentistry needs. Please complete the form below, and a member of our team will reach out if we have any questions. If you have any questions, please feel free to contact us.

New Patient Form

Please fill out our new patient registration form in its entirety to ensure we can provide you with the best possible care.

Note: Any fields with * are required.

Responsible Party

Primary Insurance Information

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