Advanced Family Dentistry Scan Insurance & ID Cards (Fishers)

Patient Information
Patient ID:
Patient Name

First NameLast Name
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Scan Your Insurance Card
FRONT of Insurance Card
BACK of Insurance Card
Scan Your Driver's License
FRONT of Driver's License
BACK of Driver's License
Advanced Family Dentistry Cancellation Policy:

If you are unable to keep your scheduled appointment with Dr. Taler, please be courteous and provide a 48-hour notice to any change in the schedule. This is regarding cancellations or rescheduling. Failed appointments will have a charge of $50.00

See our privacy policy here.

Thank you for understanding!
Dr. Taler and Advanced Family Dentistry
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