Patient Forms

As part of Dentistry By the Bay's comprehensive dental health services, it is imperative that we maintain current information on our patients. For your convenience, our patient forms are available to you in PDF format.

Patient Acknowledgement and Consent Form

  1. Save these documents to your hard drive, then open Acrobat Reader to complete the form using your computer.
  2. Print and sign the form, then mail or fax it to our office.
  3. Complete the form right in your web browser, print and sign the form, then mail or fax it to our office.
  4. Print the documents and complete them by hand, sign them, then mail or fax to our office.

Each patient must complete the Consent, Medical History and Account Information forms below (three forms).

1. Patient Contsent Form

Children 17 and Under

2. Childrens Account Information

3. Childrens Medical History

Adults 18 and Over

2. Adult Account Information

3. Adult medical History

Meet Our Doctors

Dr. Mark Mercer, D.D.S.

Dr. Mark Mercer is Michigan native raised in the Detroit area. He received his degrees from Lake Superior State University and University of Detroit. Dr. Mercer has extensive training in cosmetic, prosthetic, and implant dentistry along with additional training in orthodontics and laser surgery.

Learn more

Driving Directions

Dentistry By the Bay
2064 M-119
Petoskey, Michigan 49770

We are accepting new patients.
Call now to schedule your first appointment.

(231) 347-7471