Patient Forms

 

For your convenience, prior to visiting our office for your first dental visit, please click here to print the Medical History, Parent/Patient Information, Privacy Policy and Acknowledgement Form. (Wow, so much paperwork!) Please complete the information and bring it with you to your first visit.

 

If you are transferring from another dental office, please also fill out the highlighted areas on the Request for Records form and send it to your previous dentist, so we can have your complete dental record.

To be able to download the forms you will need Adobe Acrobat.

 

Children’s Dentistry That Makes You Smile

 

Print Forms Here: 

 

  Medical/Dental History Form 

 

Patient/Parent Payment Info

 

Notice of Privacy Practices Form

 

Request for Records Form

 

 

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