You are more than welcome to fill out our patient registration forms online and save time before your visit with Drs. Jeffrey Shambaugh and Adam Hertig. You may also have the option of printing off the PDFs of our forms and bringing them to Shambaugh Dental Group when you visit. If you have trouble accessing our forms or have questions or concerns you want to address before seeing our dentists in Fort Wayne, Indiana, please call us today!

*Online version is only avalible on Google Chrome. Click HERE to download chrome now

Downloadable Forms

View Patient Form

Online Forms

View Patient Form