Patient Forms

Dentistry for Children isn’t just a dentist office. It’s a place children look forward to visiting and where parents are just as comfortable as the patients. We make sure healthy always comes with a big dose of happy. Dentistry for Children is Where Smiles Grow.

Waiting room policy:

Parents in treatment area policy: We welcome one parent to come back per patient. Bear in mind, some patients do better without mom or dad in the treatment room. Your child may be better able to focus on treatment instructions. Plus, this gives the dentist, hygienist and your child a chance to form a trusting relationship.

  • New Patient Form

    To save a little time, you are welcome to print and complete the forms below and bring them to your first visit.

  • Privacy Notice

    This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

  • Patient Contract

    We are happy to have the pleasure of meeting your child’s dental needs. Please read carefully and sign the following new patient agreement.

  • Formas para Pacientes Nuevos

    Para ahorrar un poco de tiempo, puede imprimir y completar los formularios siguientes y traerlos a su primera visita.

  • Acuerdo de Nuevo Paciente

    Gracias por darnos el placer de satisfacer las necesidades dentales de su niño(a). Por favor lea cuidadosamente y firme el siguiente acuerdo de nuevo paciente.

  • Aviso de Prácticas de Privacidad

    Este aviso describe como su información de salud puede ser usada y divulgada, y como
    usted puede acceder a esta información. Por favor lea cuidadosamente este aviso.


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