Patient Registration
Fill Out Our Patient Registration Form to Receive Exceptional Dental Services
Are You a New Patient?
We recommend all new patients register so that we can gather vital health history information when needed. If you wish to get a head start, please complete our Health History Form (PDF).
NOTE: You cannot save your work as a file, you must print it. Please bring it with you on your first visit. If you'd like to fill out your registration by hand at our dental office, please arrive 15 minutes prior to your appointment.
Benefits of Choosing Clintonville Family Dentistry
- High-quality dental care for the entire family
- Appointments offered 7 days a week
- Emergency dental services
available
- Most insurance
plans accepted
- Friendly, knowledgeable staff
Emergency dental services
available.
Call 614-261-8700
Dr. Shirin Amini is a member of the American Dental Association, the Ohio Dental Association, and the Columbus Dental Association.