Our Easy-pay Consent

Click here to download our Easy-pay consent.

Patient Privacy Agreement

Click here to download our privacy agreement.

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Notice of Privacy Policy

Click here to download our notice of patient privacy. 

MGDC Membership Plan

Click here to download our privacy agreement.

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(voicemail only)

Michigan Geriatric    Dental Care

H E A L T H Y   S M I L E S   F O R   A   L I F E T I M E

​M A R Y  M  F I S H E R,  D D S ​​

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Patient Forms

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We always welcome new patients into our practice.  We kindly ask you prepare and either email, fax or mail the below forms prior to treatment. Please contact us with any questions!

Facility Authorization

Click here to download our dental services consent. 

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Dental History

Click here to download our privacy agreement.

SDF Consent Form

Click here to download our privacy agreement.

             Questions?  Call (248) 932-9243 

​Informed Consent

Click here to download our consent for treatment.