Patient Forms

For your convenience, our patient forms are available online. In order to save time and make the most of your visit, please bring your completed forms to your first appointment!

download adult patient form

download child patient form

Please assist us by providing the following information at your first visit:

Any panoramic X-rays taken within the past six months.
If you have orthodontic insurance, bring your insurance card. By providing this information at the first visit, we will be able to give you an estimate of your costs. Learn more >

Request a Complimentary Consultation

Patient Name*
First Last
Patient Birth Date*
Phone*
Email*
Best Location*
How did you find out about us? Select all that apply*
- Family/Friend
- Internet Search
- Dentist
- Insurance
- Social Media
- Other

Patient Forms

Request a Complimentary Consultation

Two Convenient Locations

Two
Convenient
Locations