Patient Forms

Seamless Start: Complete Your Patient Forms Here

Patient Forms

Medical & Dental Health History Forms

To save you time at your first initial visit, please download and print the Medical and Dental pdf form.

Fill it out at your leisure and bring it to your first appointment.

Medical and Dental Health History Form

“Get to Know You” Form

Fill out our “Get to Know You” form so we can get to know you better. Bring it in for your first visit.

“Get to Know You” Form

Dental Insurance Forms

ADA Dental Insurance Claim Form

Delta Dental Insurance Claim Form

United Concordia Dental Insurance Claim Form

Credit Card Authorization Form

Credit Card Authorization Form for monthly billing

Refer A Patient

A successful practice doesn’t just happen; it is the result of a strong commitment to excellence in the professional community and in the relationships we build with our patients and colleagues. We appreciate the confidence you’ve placed in us to provide you with the complete care you need, and we thank you for recommending our practice to your friends and family.

If you are here to refer a patient to our practice, please provide us with the information below. Once you’ve completed the form, click on the SUBMIT button at the bottom of the page.

Ready to streamline your orthodontic journey? Fill out our patient form today and take the first step towards achieving your dream smile.

Contact Us

Your information will help us personalize your treatment plan and ensure a smooth experience from start to finish. Let's get started—complete your patient form now!