Appointments and Forms

Patient and staff working on form at United Smile Centres

You can fill out you new patient paperwork before your appointment at the following site:

•	Online Appointment Request for Louisville and Indiana
•	Online Patient Registration for Louisville and Indiana
•	Online Medical History Form for Louisville and Indiana
•	Online Appointment Request Elizabethtown
•	Online Patient Registration for Elizabethtown
•	Online Medical History Form for Elizabethtown

Referring doctors can use the folllowing form:

•	Referral Form

If you have questions about any of the paperwork, please give us a call at (502) 899-3000 and our staff will be happy to help you.

New Patient Forms

Find Your Location

Referring Doctors

Appointments and Forms | United Smile Centres
If you have questions about any of the paperwork, please give us a call and our staff will be happy to help you.
United Smile Centres, 118 Sears Ave, Louisville, KY 40207-5014 ^ (502) 899-3000 ^ unitedsmilecentres.com ^ 9/28/2023 ^ Tags: Periodontist Louisville KY ^