New Patient Health History Form

Please take a minute to fill out the patient information form before your first appointment. Once you hit the submit button it will be sent to us.

Annual Medical Update Form (For Current Patients Only)

Please take a minute to print and fill out the patient information form before your next appointment:

HIPAA Form

Please complete this to acknowledge receipt of our HIPAA Privacy policy and to authorize the release of your medical information to other individuals that you designate.

Dental Insurance Form

Please fill out our Insurance form for your first visit or if you have new insurance.

ACH Debit Form

Our office gives you the option to have payments automatically withdrawn from your checking account.

Credit Card Authorization Form

Our office gives you the option to have payments automatically charged to your credit card.

No-No Foods List

Print out our list of foods we recommend you stay away from while wearing braces.