Patient Forms

Please first review the information shown below, and only then proceed to follow the link for the Online Patient Forms, at the bottom of the page.

The Online Patient Forms provide us important information such as medical history, dental history, dental insurance information and an opportunity to communicate any special needs for your child well before your scheduled visit.

  1. The Personal Info form may be completed only one time if the information is the same for all children.
  2. The Questionnaires - Health History form must be completed for each child.
  3. For multiple children, please use the same link provided below. 
  4. After we receive the forms, we create a file for each child, review the medical and dental history and perform a preliminary check of dental insurance.

Dental Insurance Information:  In order to use any dental insurance benefits you may have, we must immediately receive the insurance details requested on the Online Patient Forms. PLEASE NOTE:  If we are given the dental insurance information at the time of the appointment we will not be able to verify your insurance benefits, and you will be responsible for the payment in full for all services provided that day.

Remember to give us the details of all dental insurances, if any, such as another dental insurance of spouse or medical health plan with a dental rider.  In the insurance world, this is called primary and secondary insurance.  Please check with your spouse and employer’s HR department for verification of your insurances!

Link to the Online Patient Forms:  Using a desktop computer or a tablet, please complete the forms by following this secure link: Online Patient Forms.