Cohen Orthodontics, PC

Ron Cohen, DDS, MSD
“Orthodontics 3D”

FORT WAYNE
10211 Dupont Circle Drive Suite A
Fort Wayne, IN 46825
(260) 489 8989 toll free: (888) 444 2128

CHURUBUSCO
107 McCoy St, Churubusco, IN 46723
(260) 693 3452

Patient Forms

smiling mom and daughter

Please take a minute to print and fill out the patient information form before your first appointment:

  • Health History (Child) [DOC]
  • Health History (Adult) [DOC]
  • TMD History [DOC]

Fill out our Online Health History Form: [Click Here]

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10211 Dupont Circle Drive, Suite A, Fort Wayne, IN 46825
107 McCoy Street, Churubusco, IN 46723