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Patient First
Visit Information 




Your First Visit

Your initial appointment will about getting to know each other so that we can be informed about your goals and talk about your treatment options. The is usually starts with a comprehensive oral exam, radiographs and dental cleaning by one of our gentle hygienists. Dr. Pelletier will come in to exam and discuss your overall dental health and discuss a treatment plan or future dental needs on the day of your cleaning.

Send us your information and health history electronically:

  • Click on "New Patient Forms" above to sign in to send us both the patient information and health history forms over our secure website.

Please assist us by providing the following information at the time of your first visit:

  • X-Rays (if applicable) from previous dentist if less than one year old.
  • A list of your current medical prescriptions along with any allergies.
  • Please alert the office if you have a medical condition that may require pre-medication with an antibiotic prior to dental visits (i.e. artificial heart valves and replaced knee and hips performed less than two years etc.)
  • If you have dental insurance, bring the necessary information including insurance name, group and subscriber numbers. We will also need employer and date of birth of the subscriber, even if they are not a patient of the office. This will save time and allow us to help you process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.


If your dentist has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.


                Michael R. Pelletier D.M.D. 164 Elm St., Fitchburg, Ma. 01420

Office 978-345-5563 Fax 978-345-5484 Email:

A Family Dental Office Treating All Ages