Patient Info

Patient Info

New Patients

Located on the Centralia square, Dr. Rachel M. Hardin is now serving new patients of all ages!

Our new patient forms can be found by clicking the button below. The menu on the top left will guide you to the first of three documents. When you have completed all three, please hit the submit button and we will receive your information. If you need help with the forms, they can be completed in the office at your next visit.

Pre-Patient Screening

In an effort to keep all staff and patients safe, we ask that you fill out our pre-patient screening form. 

General Info

Please bring a copy of your current medications, your picture ID, your insurance card, and form of payment for copay. All copayments are due at time of service.

We accept all major credit cards along with CareCredit financing for payment. If you need help with or cannot make your payment, please contact us before your appointment.

Dr. Hardin is an in network provider for Delta Dental Primer of Missouri.

No Insurance?

 Do you need dental care, but you’re worried because you have no dental insurance at all?  Don’t worry because we have a lot of patients who are un-insured.  Speak to one of our team members to discuss how we can help you get the care you want and need


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