Patient Forms

New Dental Patient Forms – Gilbert, AZ Dentistry  

If you are a new patient to our office, you can download our new patient form below.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. 

Thank you and please call our office at 480.553.9909 if you have any questions at all.

 

New Patient Paperwork:

NEW PATIENT FORM


Post Op Instructions:

Crown, Bridges, Onlays, & Veneers Post-Op

Denture Post-Op

Extractions Post-Op

Fillings Post-Op

Root Canal Post-Op

Scaling & Root Planing Post-Op

 

 

 

 

 


 

Copper Canyon Dental is a local Arizona family and cosmetic dentistry practice serving the communities of Gilbert, Chandler, Mesa, and Queen Creek AZ. Our dentist and dental office assistants are friendly, knowledgeable, gentle and of course experienced. Dr. Mitchell Lepetich, DMD is a dentist you can trust with you and your family's dental needs. Dentist clinic services include checkups, cleanings, digital x-rays, Zoom teeth whitening, emergency dental treatment, root canals, crowns, bridges, dentures,implant supported dentures, white fillings, resin-based restorations, periodontal therapy, extractions and more. 

85224, 85225, 85226, 85248, 85249, 85286, 85242, 85243, 85240, 85233, 85234, 85295, 85296, 85297, 85298.

Contact Us

We encourage you to contact us with any questions or to schedule an appointment. Please call our office or use the quick contact form below.

If you are experiencing a dental emergency outside our business hours please contact 480-420-9905.

You may also fill out this contact form and it will be sent directly to Dr. Lepetich.