Patient Forms

Save Time At The Dentist

Visit a dentist who values your time
Complete your patient forms from home
Reduce the stress of your first appointment

1181 State Route 356, Leechburg, PA 15656

Home > Patient Forms

Enjoy the Convenience of Online Patient Forms in Leechburg

The Kiski Advanced Dentistry team wants to make it as easy as possible for new patients coming to our office. One of the ways we do this is by making our new patient forms in Leechburg, PA available online.

That’s one less thing you’ll have to worry about when you come for your first visit. We don’t want you having to juggle your driver’s license, insurance card, and other belongings while filling out paperwork.

Just fill out your forms ahead of time at your convenience and bring them with you to your appointment. If you have any questions on patient forms or anything else, give us a call at 724-294-5526. You can also schedule online. Our friendly crew will be glad to help!

Health History
Assignments of Benefits Form
Broken Appointment Policy
Demographic Form
Financial Policy

Read Why Our Patients Love Us

“ Have currently been to both there locations in oakmont had a filling put on a front tooth by Dr Bell. an its been great. Today at the kiski office Dr … Read More – Tanner K

“ Linnea was an amazing dental assistant. Dr Bell was awesome as well. They were both detailed, informative, and gentle. The front desk girls were helpful and kind as well trying … Read More – AJ F

“ I’m pretty much like everyone else when I say I hate going to the dentist. I’ve had the best experiences with Kiski Advanced Dentistry!! Dr. Bell, Danielle, Linsey and katie … Read More – Jessica R

“ I had a root canal done today and I must say the experience was flawless. I was scared to death going in there after hearing horror stories from others (not … Read More – Jessica R

“ This office and their staff are beyond professional and down to earth! Danielle is the best hygienist I have ever dealt with! If I could give this office 10 stars … Read More – Elizabeth M

“ This is the best dentist that I’ve been to. My dental hygienist, Danielle Burns, is great. She does an awesome job, she’s funny, and she’s very easy to talk to. … Read More – Jaime S

“ Literally the best place! Very kind , diligent , and gentle while guiding you through to get your teeth being the best they can! Highly recommend and glad I was … Read More – Aricca A

“ Had a filling done today by Dr. Molly and it was fast and painless. I was in and out of the office and had fun talking to the assisant Nancy … Read More – Aricca A

“ Dr.Bell knows how to make you at ease and is very knowledgeable about all aspects of dentistry. Very kind and efficient about getting you back to having good teeth even … Read More – Tim M

“ I cannot express enough how much I love this office! From the quality of service to the friendliest staff, this office is 5 stars. Both doctors were very knowledgeable and … Read More – Jordan W

“ Everyone was very nice and seems knowledgeable. Good experience! – Scott B

“ I had a good experience with the dentist and the staff. I was taken care of very gentle and fast. They are able to take care of all my needs … Read More – Brent G

“ I can’t say enough good about this Dentistry! I hadn’t been to a dentist in multiple years, developed a tooth problem, went in and they were right to the point … Read More – Nick D

“ This Dentist is amazing. I have had severe anxiety for years about going to the dentist then a friend recommended Dr Resek and I gave him a try. Totally amazing … Read More – Lori K

“ I walked into this office petrified from a bad experience I had years ago. My heart was racing palms were sweating thought about walking out but I put my trust … Read More – Virginia N

Read More Reviews

Tanner K

Have currently been to both there locations in oakmont had a filling put on a front tooth by Dr Bell. an its been great. Today at the kiski office Dr Bell did a root canal on a tooth after being nervous as heck it went Fantastic an Next day had very little pain !!! Would Recommend Kiski an oakmont Dentistry to anyone!!!!!!

AJ F

Linnea was an amazing dental assistant. Dr Bell was awesome as well. They were both detailed, informative, and gentle.

The front desk girls were helpful and kind as well trying to work with my schedule.

This location bodes a lot of fresh technology that actually makes the entire dental checkup process less invasive than I’m used to. I won’t mind at all going back every 6 months.

Jessica R

I’m pretty much like everyone else when I say I hate going to the dentist. I’ve had the best experiences with Kiski Advanced Dentistry!! Dr. Bell, Danielle, Linsey and katie have been so wonderful! The girls at the front desk have been so welcoming as well! I have multiple friends who come here as well as my boyfriend and they absolutely love it! Thank you so much for making a not so fun appointment enjoyable !!! Highly recommend !!!

Jessica R

I had a root canal done today and I must say the experience was flawless. I was scared to death going in there after hearing horror stories from others (not about this specific dentist just in general). Dr. Resek and his staff made it painless and easy. Highly recommended!

Elizabeth M

This office and their staff are beyond professional and down to earth! Danielle is the best hygienist I have ever dealt with! If I could give this office 10 stars I would!

Jaime S

This is the best dentist that I’ve been to. My dental hygienist, Danielle Burns, is great. She does an awesome job, she’s funny, and she’s very easy to talk to. I’ve also always had good experiences with Dr. Bell. They definitely make going to the dentist an easy experience.

Aricca A

Literally the best place! Very kind , diligent , and gentle while guiding you through to get your teeth being the best they can! Highly recommend and glad I was told to come here ! All the staff is super friendly and personable

Aricca A

Had a filling done today by Dr. Molly and it was fast and painless. I was in and out of the office and had fun talking to the assisant Nancy during the visit.

Tim M

Dr.Bell knows how to make you at ease and is very knowledgeable about all aspects of dentistry. Very kind and efficient about getting you back to having good teeth even if you haven’t seen a dentist for a while.

Jordan W

I cannot express enough how much I love this office! From the quality of service to the friendliest staff, this office is 5 stars. Both doctors were very knowledgeable and caring in their work delivering top notch service. I will be a patient here for a very long time!

Scott B

Everyone was very nice and seems knowledgeable. Good experience!

Brent G

I had a good experience with the dentist and the staff. I was taken care of very gentle and fast. They are able to take care of all my needs that day.thanks

Nick D

I can’t say enough good about this Dentistry! I hadn’t been to a dentist in multiple years, developed a tooth problem, went in and they were right to the point fixing it. Then I had an issue with a lot of pain and they squeezed me in ASAP! Everyone is super nice and caring! Highly recommended!!

Lori K

This Dentist is amazing. I have had severe anxiety for years about going to the dentist then a friend recommended Dr Resek and I gave him a try. Totally amazing experience. He did amazing work and I now have my smile back Thank you Dr for making me smile again.

Virginia N

I walked into this office petrified from a bad experience I had years ago. My heart was racing palms were sweating thought about walking out but I put my trust in his team. The staff was phenomenal and Dr Todd was amazing I walked out laughing after everything was done. When he was done he handed me a mirror and he only words that I could express was holy s*** I was blown away that I could smile again. Thank you to the office the staff and Dr Todd. I would recommend them to anyone and I will be returning there.
Thank you just isn’t enough for what they did for me.