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    • Schererville Office Location
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Schererville
(219) 322-8008
Munster
(219) 836-0888
Valparaiso
(219) 531-0544
Appointment Request
AAC Orthodontics Logo
Schererville
(219) 322-8008
Munster
(219) 836-0888
Valparaiso
(219) 531-0544

Office Visits | Financial Information | Before and After | Office Tour | Patient Forms | Financial Calculator

Patient Forms

patient forms

Please fill out and print the patient history forms and privacy acknowledgement before your first appointment:


  • Medical/ New patient form
  • Medical/ New patient form SPANISH

 

  • HIPAA Privacy Acknowledgement & Notice
  • Insurance Information Form
  • TMJ Questionnaire
  • HIPAA Amendment

If you're unable to open PDF files, you can get Adobe Reader® for free.

Office Visits | Financial Information | Before and After | Office Tour | Patient Forms | Financial Calculator

Office Location Map Office Location Map Office Location Map
Schererville 312 East US 30
Schererville, IN 46375
(219) 322-8008
Munster 8165 Calumet Ave
Munster, IN 46321
(219) 836-0888
Valparaiso 2262 W Morthland Dr
Valparaiso, IN 46385
(219) 531-0544
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