Save Time! Our Form Is On Line.

Here are links to the medical history form new patients are asked to fill out. Click, print, fill it out and you're already ahead. (Form will open in a new browser window. Adobe Acrobat Reader--search under Programs on your Start button--is required to open/print these forms.)

  • Medical History Form (Please be patient, make take a few minutes to download - will open in a new window)
  • Financial Policy (Please be patient, make take a few minutes to download - will open in a new window)

Here's How to Reach Us

Mail

Fort Wayne Smiles, P.C.
Dr. David Reichwage
2031 Reed Rd.
Fort Wayne IN 46815

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Telephone

(260) 426-1086

Email


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