Patient Forms

Forms for New Patients

To help make your experience as smooth as possible,
please bring forms 1, 2 and 3, signed and completed to your child's First Visit:

(click to download)

1) Patient Information / Medical History Form

2) Consent & Financial Policy

3) Authorization for Release of Dental Records and X-rays

4) Nitrous Oxide Informed Consent

5) Consent For Conscious Sedation

6) COVID-19 Screening Form

At the First Visit we will review and discuss your child's health history, provide a complete oral exam, and assess their risk for developing any future conditions. Only the necessary radiographs (X-rays) will be taken to provide us with a complete evaluation of your child's oral health status. A thorough cleaning of the teeth and fluoride application may also be performed.

We have learned that success comes easiest when the parent is an active part of our dental team.

We look forward to meeting you, and giving your child something to smile about!

See you soon!