ACCESSIBILITY Accessibility
Patient Forms


 

 ***PLEASE READ BEFORE YOU BEGIN***

Instructions for patient forms

  1. Once a link is clicked, the "ONLINE INTAKE PROCESS" screen will appear.
  2.  To protect your data a verification code is required and is only sent via text.  A cell phone is needed for this code.
  3. ***ENTER YOUR CHILD'S NAME***  This is very important!!
  4. Close the previous browser before beginning a new form or child.

 FYI:

  • A new verification code and a new intake process is needed for each child.  Returning to this page and clicking the appropriate link will generate a new code. 
  • All forms will need to be done online.  For safety reasons paper forms are not available.
  • Please choose ONE cell number and ONE email for your entire family.
  •  If your child is older and wants to use their cell phone and email for communication, this will change the contact info for your entire family.  We will need to create a separate account for them.  Please call us to set this up prior to filling out forms.



 

Are you new to our office?

If you have never been seen in our office or it's been 3 years since your last visit click here:  New Patient Bundle

Inactive or new dental insurance?

If you received a notification regarding dental insurance information click here:  Insurance Bundle

Time to update?

If we sent you a request to update information click here:  Update Bundle



This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free