Patient Forms

Make life easier by filling out the following forms in the comfort of your own home! That will save you time when you get to our office.  Simply click on the Patient Information and Patient Medical History forms below, to instantly download.  Then fill in the information and bring them with you to our office! We look forward to meeting you!

PATIENT INFORMATION FORM- CLICK TO DOWNLOAD

PATIENT MEDICAL HISTORY- CLICK TO DOWNLOAD

Contact Us

Call us: 801-785-8308
Email Us: Blakedental@gmail.com

198 South Main Street
Pleasant Grove, UT 84062

Hours

Monday: 8am-5pm
Tuesday: 10am-6:30pm
Wednesday: Closed
Thursday: 9:30am-6pm
Friday: 8am-5pm
Same Day Emergency Care 24/7

Meet Dr. Blake