Dr. Farah Khan Pediatric Dentistry

(734) 254-0786

45535 Hanford Road · Canton, Michigan 48187

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New Patient Forms

We know your time is valuable. In an effort to expedite your wait time, you may download and complete the medical history form below and bring it with you to your first appointment. We look forward to meeting you and your child!

NEW PATIENT FORM

NOTICE OF PRIVACY PRACTICES

Request Appointment

We maintain strict standards and procedures to prevent unauthorized access to your personal information and ensure correct use of information. While we strive to protect your personal information, we cannot ensure the security of any information that you transmit to us over the internet and you do so at your own risk. However, once we receive your transmission, we take reasonable steps to ensure that your information is secure on our systems.