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Flack and Stone
  • About Us
    • Why Choose Us
    • Our Doctors
  • Locations
    • Blue Springs
    • Lee’s Summit
    • Sedalia
    • Warrensburg
  • Services
    • Anesthesia
    • Bone Grafting
    • Dental Implants
    • Exposure of Impacted Teeth
    • Extraction of Impacted Teeth
    • Extractions
    • Frenectomy
    • Pre-Prosthetic Surgery
    • Wisdom Teeth Removal
  • New Patients
    • New Patient Forms
    • Insurance & Financial Options
    • Request Appointment
    • Patient Reviews
  • Blog
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New Patients

New Patient Forms

Thank you for choosing Flack & Stone. We look forward to serving you! We have provided our new patient forms below to help streamline your check-in process for your first visit.

Please print and complete the forms below and bring with you to your appointment.

  • Informed Consent Release
  • Dental and Medical Insurance Notice
  • Medical and Dental History
  • Patient Information
  • Insurance & Financial Options
  • New Patient Forms
  • Patient Reviews
  • Request Appointment
New Patients
Locations
Request Appointment

About Us

We are your hometown providers located in downtown Lee’s Summit, Blue Springs and Sedalia. We will provide high quality care for you and your family.

Locations

Blue Springs, MO
Lee's Summit, MO
Sedalia, MO
Warrensburg, MO

New Patients

New Patient Forms
Insurance & Financial Options
Request Appointment
Patient Reviews

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