Patient Online Forms
ADULT FORMS- Please fill out the online forms completely. Your online forms will be delivered to us safely and securely. We will see you soon.
CHILD FORMS - Please fill out the online forms completely. Your online forms will be delivered to us safely and securely. We will see you soon. Authorization of Medical Release
Authorization of Medical Release - a release of records is necessary for the transfer of your current x-rays from your previous office to us, please fill out this form and send/fax it to them. This will expedite the transfer of your current x-rays to us saving you time and money. Thank you.
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What To Expect
Being well-prepared for your appointment will ensure that Dr. Bailey has all of the needed information to provide the best possible care for you. Make a list of any problems, concerns or questions to help relieve any unnecessary anxiety you may be feeling. Your first visit to our office will include a comprehensive dental examination and any necessary xrays will be taken. Our Drs. and team understand that emergencies happen and we make it a priority to make you comfortable when you need us most . You may want to review our team page to familiarize yourself with Dr. Terese and Richard and their team. We look forward to your first visit.
See What Our Patients Are Saying:
"Thank you for making me feel so comfortable within your family dental office. From the first phone conversation I had...you each have given me a comfort level that I truly appreciate...your communication efforts of my concerns makes me feel I have found my dental home. Thanks, each of you, once again, for going the extra mile." -- Jim W.
"Thank you to all of you wonderful people! The whole team is top of the game. I honestly have never felt so comfortable and well taken care of by a team that truly cares." -- Jeremy Y.
"AMAZINIG...You were perfect A+... Thank you Dr. Richard for getting my tooth fixed. I hope I never need another root canal, but if I do, I pick you!"" -- Terri D.
"Assistants and Doctors were professional and excellent... I like watching the movie during treatment." -- Scott P.
"My children love coming to the dentist now...the hygienists are so nice...they make it fun for them." -- Jennifer M.
"I was blown away by the fact that I was charged less than what I was quoted. I've never been to a dentist that helped save me money...I was very impressed by how friendly everyone is and how well I was treated. I've never had this exceptional treatment before and I appreciate it very much!...I definitely recommend you guys whenever I can and you deserve it... Ryan R.
"This is such a great place...Thanks for everything you do for us." Lisa V.
Bailey Family Dental is conveniently located about 3 miles north of I94 just east off of Hwy 83 or just south of Hwy 16 off of Hwy 83. We are located just south of the Piggly Wiggly grocery store.