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Mertes Pediatric Dentistry
Greg Mertes, D.M.D.
5655 Hudson Dr.
Hudson, OH 44236

330.655.KIDS (5437)

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Save Time - Download Forms Today

While we offer these forms in office, you can save time by downloading them here. Complete them at home and bring them to the office when you arrive.

By doing this ahead of time, you can relax, enjoy the atmosphere, talk to your child, and help make this a positive experience together.

Forms require Adobe PDF Reader to view.
Click here to download Adobe PDF Reader.




HIPPA (side 1)
(Don't forget side 2)



HIPPA (side 2)
(Don't forget side 1)



Demographic Info

Medical/Dental History





Kids Coloring Corner
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