New Patient Forms Contact Us Learn More About Our New Patient Forms Thank you for choosing our practice! We are eagerly anticipating your upcoming visit. The following forms need to be completed for each individual patient prior to treatment in our office. New Patient Information Form Health History Form HIPAA Notice of Privacy Our Location7210 Maplecrest RdFort Wayne , IN 46835 Contact UsMain Phone: (260) 485-5530Facebook: Dr. Jacob Family Dentistry Business Hours Mon, Tue, Thu: 8:00 am – 6:00 pm Friday: 8:00 am – 2:00 pm Wed, Sat, Sun: Closed Pay Online