BATTLE CREEK ENDODONTICS
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Patient Forms

We look forward to seeing you at your upcoming appointment. For your appointment we ask that you download, print and fill out the Patient Form below as well as bring the following information:
  • Please arrive 15 minutes prior to your appointment time
  • Copy of current insurance card(s)
  • List of current medications
  • List of allergies, including latex 
  • Co-Pay for service(s)
Patient Forms
Please review privacy policy before completing Patient Forms.  You do not need to print the Privacy Policy.
Privacy Policy


If you have any questions or concerns please feel free to contact us before your appointment. 
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497 E Columbia Avenue
Suite 14, Oakridge Office Center
​Battle Creek, MI  49014
Office Phone: (269) 660-0747
Office Fax:  (269) 441-2736
Email: [email protected]
Hours: 
Monday - Thursday 7:45 am to 5:00 pm*
Friday 8:30 am to 12:00 pm
*Closed for lunch 12:00 - 12:45 pm

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Battle Creek Endodontics
Dr. Eric T. Shugars, DDS, MS, PLC
​
Copyright © 2019
GENTLEWAVE and the GENTLEWAVE logo are registered trademarks of Sonendo, Inc. and used under license. 
​
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  • Home
  • Our Team
  • GentleWave
  • Contact
  • Patient Forms
  • Patient Education
  • Employment