New patients welcome
Eastgate Family Dental
Whether you're new to Grand Rapids or just looking for a fresh start, you're in the right place.
What to Expect on Your First Visit
Going to a new dentist can feel a little nerve-wracking. That's why we take our time with every new patient, answer every question, and make sure you feel comfortable before we do anything else.
A warm welcome
You'll be warmly greeted and we will answer any questions.
Getting to know you
We'll review your dental history and talk about any concerns. No judgment, no pressure.
A thorough exam
Dr. Jankowski or Dr. Kahn will do a comprehensive exam, including x-rays if needed.
Your personal plan
We'll explain everything we find and work with you on a plan that fits your needs and your budget.
You're part of the family
Before you leave, we'll schedule your next visit and make sure you feel great about your care.
What to Bring
New Patient Forms
Want to save time on your first visit? Fill out your forms ahead of time and bring them with you. Open any form below, fill it out on your device, then print using Ctrl+P on Windows or Cmd+P on Mac. Or print blank and fill out by hand — whichever works best for you.
Adult new patient forms
First-time adult patients should print and complete all five forms.
- Patient Registration Form Basic personal, contact, and insurance information.
- Dental & Health History Form Your dental history, medical conditions, medications, and allergies.
- Financial Policy Our payment and insurance policy. Read, initial each section, and sign.
- Patient Acknowledgment & Consent Form HIPAA acknowledgment and consent to treatment.
- Notice of Privacy Practices How we protect and use your health information. Sign and return.
Child new patient forms
Bringing a child for their first visit? Print and complete all four forms.
- Child Patient Registration Form Child's personal information, parent/guardian details, insurance, and medical and dental history.
- Financial Policy Our payment and insurance policy. Read, initial each section, and sign.
- Patient Acknowledgment & Consent Form HIPAA acknowledgment and consent to treatment on behalf of your child.
- Notice of Privacy Practices How we protect and use your child's health information. Sign and return.
Transferring from another dentist?
- X-Ray & Records Transfer Authorization Authorize your previous dentist to release your records and x-rays to our office.
Prefer to fill them out in the office? No problem. Just arrive 15 minutes before your appointment and we'll get you set up.
Insurance? We've Got You Covered.
We bill most PPO and dental insurance plans as a courtesy. Our team will verify your benefits before your appointment and handle the paperwork so you can focus on your care, not the fine print.
No insurance? Our in-house Eastgate Membership Plan is built for patients who pay out of pocket. It covers your preventive care at a flat annual rate and includes discounts on everything else.
Questions about coverage? Call us at (616) 245-9830 and we'll sort it out before you even come in.
Nervous About the Dentist? You're Not Alone.
We hear it all the time: "I haven't been to the dentist in years." And you know what? That's okay. There's no judgment here. Just genuine care and a team that wants to help you feel comfortable.
We go at your pace. We explain every step before we do it. And if you need a break, just raise your hand. You're in control.
Ready to Take the First Step?
Book Your First VisitWe're Accepting New Patients
Join the Eastgate Family. We can't wait to meet you.