Maggie A. Kleem, DDS
352 West Bagley Rd
Berea, OH 44017
(440) 239-8389
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New or Existing Patients:​
For your convenience, we have added a new button to complete all your forms right online and to speed things up before arriving to your appointment. Just click the "complete forms online" button below and away you go.

Complete Forms Online

​OR ... If it is easier for you, you can still download, print and complete the needed forms right at home. It's your choice just simply follow steps 1, 2, and 3 below and remember to bring all of your completed forms with you for your appointment and we will get you started right away!

1

New patient and Medical History forms (Print, Complete and Sign)

Patient Registration
Medical History

  2

HIPAA, Financial and Appointment Policy (Read Completely and Sign Form)

HIPPA, Financial and Appt. Policy, Signature Page

  3

Disclaimer (Be sure to Read Completely)

Disclaimer

* Please bring ALL the above forms at your first visit *
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