Please print and fill out the highlighted forms and bring them to your first appointment if possible.
Registration
Health History
Receipt of Privacy Act
Financial Agreement
Notice of Privacy-page 1
Notice of Privacy-page 2
Muizz Merchant, DMD
D. Mike Cvetkovic, DDS
Heidi Novack, DDS
6686 Joliet Road
Indian Head Park, IL 60525
Bookmark our webpage !
www.indianheadparkdentistry.com
email us at:
mthreedental@gmail.com
dmcvetkovicdds@gmail.com
Monday 9:00am - 6:00pm
Tuesday 10:00am - 7:00pm
Wednesday Closed
Thursday 9:00am - 6:00pm
Friday 8:00am - 1:00pm
Saturday Closed
Sunda Closed
