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Parrish Orthodontics

  • Maplecrest

  • Jefferson

  • Tillman

  • Huntington

  • Bluffton

  • Churubusco

  • Van Wert

  • Paulding

  • Home
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    • Visit our Office: Maplecrest Road, Jefferson Blvd, Tillman Road, Bluffton, Churubusco, Van Wert, Paulding
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Patient Forms

patient-formsFor your orthodontic consultation, please complete the appropriate Health History Form and the HIPAA authorization form prior to your first visit at Parrish Orthodontics.
  • Adult Patient History and Sleep Questionnaire
  • Child Patient History and Sleep Questionnaire
  • HIPAA Authorization

For an TMD or SLEEP APNEA CONSULTATION, please complete the appropriate Form and the HIPAA authorization form prior to your first visit at Parrish Orthodontics.

  • TMJ Questionnaire
  • Snoring Questionnaire
  • HIPAA Authorization

These documents are in PDF format. If you’re unable to read PDF files, you can download Acrobat Reader free from Adobe.

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Maplecrest Road

5715 Maplecrest Rd.

Fort Wayne, IN 46835

(260) 209-6613

Huntington

133 E Northpoint Ave.

Huntington, IN 46750

(260) 447-2568

Bluffton

116 E. Dustman Road

Bluffton, IN 46714

(260) 447-2568


Jefferson Blvd

5215 North Bend Dr.

Fort Wayne, IN 46804

(260) 436-2118

Churubusco

3985 N. US 33, Ste. 103

Churubusco, IN 46723

(260) 693-2656

Paulding

402 E Baldwin Street

Paulding, OH 45879

(260) 447-2568

Tillman Road

223 E. Tillman Rd.

Fort Wayne, IN 46816

(260) 447-2568

Van Wert

1167 Westwood Dr., Ste. 100

Van Wert, OH 45891

(419) 238-2004

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