Call: (734) 485-4600

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Patient Forms

We want to welcome you to the Washtenaw Dental family!

New patients are always welcome here. Everyone at Washtenaw Dental is committed to making your visits pleasant and stress-free. You can count on our friendly, highly experienced staff to always provide the highest standard of dental care in a clean, state-of-the art environment. Your comfort is our top priority.

To make things convenient for our new and existing patients, we send your forms through text which you can fill out on your phone. Or for those who prefer, you can print out the physical forms to bring with you.

If you prefer, print and bring forms to upcoming appointments or e-mail completed forms to (Please note: forms e-mailed to this address are not encrypted.)

We look forward to seeing you soon!

Dr. Adam Hassan, Dr. Dennis Donoho and the Washtenaw Dental team

Click below to download New Patient Registration Materials