Westerville Endodontics

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Patient Forms

CALL TODAY: (614) 882-8000

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  • Home
  • About Us
  • What is an Endodontist?
  • Our Providers
  • Services
    • Root Canals
    • Root Canal Retreatment
    • Apical Surgery
    • Abscessed Tooth Treatment
  • Financial Options
  • Contact Us & Location
  • Patient Forms
  • Request an Appointment

Patient Forms

Thank you for selecting Westerville Endodontics for your endodontic care. To schedule an appointment, please call us at (614) 882-8000 or use our online appointment request form.

Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring forms with you to your first visit along with any diagnostic films that may have been ordered or performed by another dentist.

Downloadable Forms:

  • New Patient Registration
  • HIPAA
  • Consent Form

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

Westerville Endodontics

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Westerville Endodontics

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  • What is an Endodontist?
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  • Financial Options
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45 Huber Village Boulevard, Westerville, OH 43081

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At Westerville Endodontics, Dr. Vicki M. Houck and Dr. Saadia Bukhari provide endodontic care to patients in Westerville, OH. Our endodontic services include Root Canals, Root Canal Retreatment, Apical Surgery, and Abscessed Tooth Treatment.

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