Thomas Nykamp, DDS

A Family Dentist Practice, General, Cosmetic, and Restorative Dentistry

New Patient Information Form Upload

Send Your New Patient Information
Form to the Dentist Office

┬áIf you are a new patient and have downloaded and completed the New Patient Information Form, you may send it online to Dr. Nykamp’s office using the form and process below.

Click Here for Detailed Instructions If Needed

Attach the completed New Patient Information Form that you saved to your computer.

Only a PDF document type will be accepted.

If you downloaded and printed have filled out the New Patient Information Form by hand, and have scanned the completed form – make sure you have saved the scanned document as a PDF file type..

After you have attached the fill, read and accept the Consent, Authorization and Release Policy, Check the box below to confirm that you have read the policy – click the “Submit” button.

You should see an onscreen confirmation of your submittal as well as you will receive a confirmation email within a few minutes..

New Patient Dental Information
  • Accepted file types: pdf, Max. file size: 3 MB.
  • This field is for validation purposes and should be left unchanged.

Contact Us

Call: 616-452-5721

2540 Woodmeadow ST SE
Grand Rapids, Michigan 49512

Working Hours

M, W, Th 8:00-12:30 pm; 2:00-6:00 pm
Lunch: 12:30 – 1:45 pm
Tues. 1:00-8:00 pm; Closed Fri – Sun