Patient Forms

Please take a minute to submit the online Electronic Health History form prior to your first visit. Or, if you prefer, print and fill out the Child and/or Adult Health History form and bring it with you to your first appointment:

• Online Health Form
• Patient Form (Child)
• Patient Form (Adult)

In addition, please review and complete the following and bring them to your appointment as well.

• HIPAA: Notice of Privacy Practice
• HIPAA: Acknowledgement of Privacy Practice
• Getting to Know You questionnaire
• Photo Release Form

Join our Junior Smiles Club! The Junior Smiles Club is dedicated to our future patients who are not quite ready for braces. Fill out this form and bring it to our office to receive your free gift and become the newest member of our club.

• Junior Smile Club

If you’re unable to open PDF files, you can get Adobe Reader® for free.