Skip to main content
Click for menu
Click to call our office
Link to Dr. Rod Maxfield, DDS home page
Dr. Rod Maxfield, DDS
Dr. Rod Maxfield, DDS Facebook page Dr. Rod Maxfield, DDS Instagram page
31 West 100 South, Suite A
Pleasant Grove, UT 84062
Pleasant Grove Office Phone Number 801-785-2631
Learn more about Contact Us

  • Home
  • About Us
    • Meet Us
    • Who’s Who in Dentistry?
    • Family Dentistry
    • Our Blog
    • Reviews
  • Patient Info
    • First Visit
    • Insurance
    • Payment Options
      • Monthly Payment Plans / OAC
    • Forms
    • Post-Op Care Instructions
  • Preventative Care
    • Dental Hygiene
      • Oral Hygiene Basics
      • Periodontal Care: Gum Disease
    • Custom Mouth Guards
    • Fluoride
    • Adult Sleep Apnea
    • Pediatric Sleep Apnea
    • Infection Control
  • Restorative Care
    • Fillings
    • Crowns
    • Bridges
    • Dentures
    • Material Upgrades
  • Oral Surgery
    • Wisdom Teeth
    • Implants
    • Bone Grafting
    • PRF
    • Sedation & Happy Gas
  • Endodontics
    • Root Canal Therapy
  • Technology
    • X-Rays & Intraoral Photos
    • 3D Imaging
    • Laser Treatment
  • COVID-19
    • COVID-19
    • Infection Control
  • Contact Us
    • Contact Us
    • Office Hours

Dentistry Making a Difference

Learn more about Home
Learn more about Patient Info
Learn more about Contact Us

Forms



Please fill out the appropriate forms and bring them with you to your appointment.

General & New Patients

  • COVID-19 Consent Form

  • Health History

  • Insurance Info

Procedure Consent

  • Bone Graft Consent

  • Bridge Consent

  • Crown Consent

  • Denture Consent

  • Extraction Consent

  • Fillings Consent – Amalgam

  • Fillings Consent – Composite

  • Implant Consent

  • Pulpotomy Consent

  • Root Canal Consent

  • Scaling & Root Planing Consent

  • Sealants Consent

  • Sedation Consent

  • Wisdom Teeth Consent

Patient Info
  • First Visit
  • Insurance
  • Payment Options
    • Monthly Payment Plans / OAC
  • Forms
  • Post-Op Care Instructions

Serving The Following Cities:
Pleasant Grove UT • Lindon UT • American Fork UT • Orem UT • Highland UT
Alpine UT • Vineyard UT • Cedar Hills UT

Dentistry Making a Difference!​

Dr. Rod Maxfield, DDS Facebook page Dr. Rod Maxfield, DDS Instagram page
31 West 100 South, Suite A
Pleasant Grove, UT 84062
Tel: Pleasant Grove Office Phone Number 801-785-2631 Fax: 801-785-7376
  • Home
  • About Us
  • Patient Info
  • Preventative Care
  • Restorative Care
  • Oral Surgery
  • Endodontics
  • Technology
  • COVID-19
  • Contact Us
  • Disclaimer
  • Sitemap

Dental Website Design by PBHS © 2026

Scroll to the top of the page
Click to open and close visual accessibility options. The options include increasing font-size and color contrast.