A smiling orange tooth icon

Online Forms

We're thrilled to provide comprehensive care for your child's dental needs. To streamline your experience and ensure efficient service, please take a moment to complete the following online forms.

New Patient Forms

Get

Acquainted

New patient information.

Please fill out one form per family.

Download

Medical

History

Medical history for the child.

Please fill out one form per patient.

Download

Billing

Forms

Our office's Missed Appointment Policy and Credit Card Authorization.

Download

Insurance Agreement

View or download our office's insurance policy

Download

Existing Patient Forms

Release of

Records

Request to transfer records to another office.

Download

Oral Health

Assessment

Kindergarten oral health assessment form.

Download

Nitrous Oxide

Consent Form

Informed Consent paperwork for Nitrous Oxide.

Download

Emergency Visit
Registration

View or download our patient paperwork for an emergency visit.

Download

Missed Appointment
Policy

View or download our office's missed appointment policy.

Download

Credit Card
Authorization

A form to securely leave a credit cardon file within our office.

Download

Insurance Agreement

View or download our office's insurance policy

Download

Referring Doctors

Referral Form

Click here to download our office's referral form.

Download
If you are interested in scheduling an appointment, please don't hesitate to contact us - our team is waiting to meet you!