Patient Forms

To save you time when you arrive for your first appointment, you can complete some of the new patient forms before your appointment date. We can mail or e-mail patient forms to you and you can complete the information before coming into the office and bring the paperwork with you to your appointment. Alternatively, you can click on the pdf links below to print, complete and bring the paperwork with you into the office for your appointment. Maybe the best option of all, is to click on the Online Forms below, complete the information and click Submit at the bottom of each of the two forms. We will then have the information in our office before your appointment!

Online Forms

Child Patient Form
Adult Patient Form

Forms to Complete and Bring to Appointment-

Patient Information (2 pages)
Medical Information (2 pages)
Insurance claim form – the insured should sign at both X’s
Acknowledge of Receipt of Notice of Privacy Practices (2 pages)
Consent for Orthodontic Exam and Records

Information Forms

Notice of Privacy Practices
Summary of Informed Consent and Office Policies
Financial Policy and Payment Options