New Patients

Patient Forms, Map and Directions to Republic Office

Your first visit to Simply Smiles Family Dental involves a few special steps so that we can get to know you.  To understand what to expect, 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.  There's also background information about our committed staff and our first visit procedures.  When you set up your first appointment, you will receive a link by text and email to complete your necessary paperwork.  We appreciate you handling this at your earliest convenience.  

Also, if you have been a patient at another dentist prior to your first visit with us, be sure to have that office email us your most recent x-rays and dental history.  They can send them to us at [email protected] 

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.
  • Ensure a compassionate and professional environment. 
  • Exceed your expectations.


Patient Forms and Online Pay
Our office has moved to a new Patient Management System to better serve you!  After scheduling your appointment, we are asking ALL patients to fill out the patient registration forms online to create or update your records.  If you have all of your dental and medical insurance information handy, this should take about 20 minutes. Be sure to fill out the form completely and include your group number and subscriber/member ID if you have dental insurance.  Do this when you can complete it without interruption as the system may time you out.  IMPORTANT:  be sure to hit "SAVE" at the end of inputting all of your information so your work will not be lost.  Future updates to your profile will only take a short amount of time and allows you to handle your paperwork prior to coming to our office.  

If you can't access these documents or have trouble filling them out, be sure to arrive 20 minutes early to complete your paperwork.  And be sure to bring your insurance cards with you to your appointment.

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 unnecessary anxiety you may be feeling.  Educate yourself on your symptoms by reviewing the Patient Education information on this website.  Also, take some time to review our staff page and familiarize yourself with our team.  We look forward to your first visit!

Contact Us

Send Us an Email

Our Location

1093 US Highway 60 E Republic, MO 65738

Hours of Operation

Lunch: 12:30 PM - 1:30 PM

Simply Smiles Family Dental


8:30 am-5:00 pm


8:30 am-5:00 pm


8:30 am-5:00 pm


8:30 am-5:00 pm