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Patient Forms

Download Patient Forms

Speed up your check-in process by filling out the required forms in advance. All new patients need a completed New Patient Form and a Health History Form for each service they will be receiving (Dental, Vision, Orthodontics). And, if the patient is a minor and someone other than the patient's legal guardian is accompanying him or her, please complete the Legal Guardian Authorization for Minors form.

 

New Patient Forms

New Patient Form - English

New Patient Form - Spanish

Dental Patient History

Dental Health History - English

Dental Health History - Spanish

Vision Patient History

Vision Health History - English

Vision Health History - Spanish

Orthodontic Patient History

Orthodontic Medical History - English

Orthodontic Medical History - Spanish

Is someone other than the patient's legal guardian accompanying a minor?

Legal Guardian Authorization for Minor - Bilingual