Patient Forms, Map and Directions to Mason Office
Welcome to our practice! Your first visit to Kempeinen Dentistry establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms
- Patient Registration
- Medical History Form
- HIPAA Acknowledgement And Consent Form
- Transfer Of Records
- Financial Agreement And Insurance Protocol
- Missed Late Appointment Policy
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: 
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any anxiety you may be feeling. Take some time to review our staff page and familiarize yourself with the doctors.
If you have had recent xrays (within 5 years), we can help you to retrieve them from your previous office! If not, then the doctor will help determine which xrays are warranted for your dental situation.
A thorough exam will be completed to determine if there are any problems that should be addressed. The dentist will explain any issues and their treatment options in plain english. This is a good time to propose any questions or concerns that you may have with your teeth. A plan will be developed for your dental care, and costs/insurance coverage will be discussed.
We look forward to your first visit!