Patient Forms

The first visit to our office is designed to get you better acquainted with all we offer as well as introduce you to Dr. Rebecca and our caring team. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs.

Click the Form below to download

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Patient Information and Medical History


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Dental History


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Destination Dentistry
Dr. Rebecca Kretschmar
At Destination Dentistry, we offer a wide variety of dental services, including cosmetic and family dentistry, as well as sedation dentistry and TMJ treatment. Call us today to schedule an appointment if you are in Custer or Black Hills area.
141 N 5th St
Custer, SD 57730
Call: 605-673-2011605-593-9821
info@destinationdentistry.net
Testimonials
  • We have been to many dentist's and this is the first one we don't mind coming back to. Very friendly staff and excellent work! Couldn't be happier and so glad a friend told us about them 😊
    —Bissell F.
  • Outstanding dental care. Dr. Rebecca was very thorough so she discovered problems that my previous dentist missed. The staff is warm, friendly, caring and efficient. There is no reason to drive to the city for excellent dental care.
    —Lee F.
  • …I had no discomfort (with the laser). Yes, an awareness of ’something done’, but no pain what so ever! You did a good job Doc. If anyone wants to ask me, I’ll tell them. It’s time for the old Bard Parker blade to be relegated to the history file. Thank you for your skills.
    —Dr. Art L., M.D.
  • Congratulations on your beautiful Hi-tech office-and on your thirty years of working together! Also you need to know I appreciate the picture you sent me of my teeth. They are absolutely the best pictures I have ever taken. Thank you for the good service you provide.
    —Arlene B.
  • I enjoyed meeting Dr. Rebecca. The information that she shared with me was greatly appreciated. She has a nice confident way about her.
    —Jackie H.
  • Everyone was great as usual….it was great meeting Dr. Rebecca. (my wife’s) term for her was “delightful” and I concur.
    —John C.

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