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