Patient Registration Form Please view and fill out our “New Patient Registration Form” online before your visit. If you have any questions regarding the form below please contact us! Canton – (734) 981-4909 Howell – (810) 632-2241 Redford – (313) 533-8150 South Lyon – (248) 446-9113 The Smile You've Always Wanted! Our Locations CantonHowellRedfordSouth Lyon Navigation HomeAboutServices Forms Patient Registration FormOffice Policies FormHIPAA Form