The forms below are provided for your convenience. Please complete forms required by Metro West as deemed fit by our office. You can view/print the documents below, or you can right-click and save or print them from home. Please fax completed forms to (402) 614-7122, or email them to metrowestdental@gmail.com


Patient Forms


Please choose from the following forms below. You will have the option of filing out the form online, or you may download and print digital copies to mail in or drop off in person.

Getting Acquainted Form

Download PDF
If you are a new patient to Metro West, complete this form first.



HIPPA Forms

Download PDF 1 & PDF 2
Read the privacy policy carefully and complete the form acknowledging your receipt.


Dentist Forms


Referring Dentist Form

Download PDF
This form is for other dentists referring a patient to Metro West.