Patient Services (877) 313-6232
Corporate Services (231) 547-7638

Patient Forms

Your Responsibilities and Rights as an MCDC Patient

In order to maintain the reduced fees that MCDC is able to offer our patients, it is critical that we make the most effective use of our time. Missed appointments, late arrivals, and last-minute cancellations prevent us from utilizing our time appropriately, and this affects all of our patients. To help eliminate these occurrences, MCDC has instituted a no-show policy that will be discussed with you at your first appointment.

In addition, before MCDC personnel can treat you, you must consent to allow this treatment to be performed.

Finally, as an MCDC patient, you have a right to expect that we will maintain the confidentiality of your dental records.

The provision of services to individuals based on race, color, sex, national origin, disability, religion, or sexual orientation will not be denied services. Accommodations will be made for individuals who have the inability to pay due to verifiably insufficient income.

Patient Policy
Terms of Use
Notice of Privacy Practices

Your First Appointment

When you arrive at the clinic for your first appointment, you will be asked to read some information and provide some personal history:

  • A form confirming that you have read and understand MCDC’s Cancellation policy, Consent for Treatment acknowledgment, and your right to privacy notification.
  • A patient information and health history form that we will scan into your permanent patient record.

You can save time at your appointment by downloading and printing these forms and completing them before you arrive at the clinic. Simply click on the following links to do so:

Treatment Consent Form
Patient Health Information Form
Formulario de Información de Salud del Paciente
Patient Appointment Policy
Nuevas Formas de Pacientes

MCDC’s Promise

Read MCDC’s Promise to Our Patients.

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Our Services

Setting the highest standard of oral health care

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    Tooth Removal

    While the goal of most patients and dentists is to ensure you don't lose any tee

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    Emergency Dental Care

    If you experience a dental emergency, be sure to call us as soon as possible. If

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    Sedation Dentistry

    Sedation dentistry allows your doctor to provide a variety of dental treatments

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    Hospital Services

    There are special occasions in which patients are unable to have their dental ca

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    Periodontal Treatment

    If you've been diagnosed with gum disease, there are a variety of treatment opti

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    Digital X-Rays

    Using the most advanced dental technology possible is just as important as stayi

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    Pediatric Dentistry

    A child's first visit to the dentist should be enjoyable. Children are not born

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    Wisdom Teeth Extractions

    Wisdom teeth are types of molars found in the very back of your mouth. They usua

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    Sealants

    Sometimes brushing is not enough, especially when it comes to those hard-to-reac

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    Root Canals

    In the past, if you had a tooth with a diseased nerve, you'd probably lose that

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    Nightguards

    If you often wake up with jaw pain, earaches, or headaches, or if you find yours

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    Flouride Treatments

    Fluoride is effective in preventing cavities and tooth decay and in preventing p

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    Fillings

    A filling is a material used to fill a cavity in a tooth.  There are two types:

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    Dentures

    Dentures are a removable replacement for missing teeth. There are two types of d

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    Crowns

    Crowns are a way to improve your tooth’s shape/appearance or to strengthen a t

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    Bridges

    A bridge may be used to replace missing teeth, help maintain the shape of your f

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    Oral Exams & Cleanings

    If you experience a dental emergency, be sure to call us as soon as possible. If

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