Patient Forms
Please do not fill out Patient Forms without a
scheduled appointment. Thank you!
Patient Forms
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Health Questionnaire
Please fill this form out 24 hours prior to your child's scheduled appointment.
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Consent for Treatment of a Minor
Parent/Legal Guardian to fill this form out when they will NOT be present to accompany their child(ren) to their dental appointment.
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Consent to Discuss Health Information
Parent/Legal Guardian to fill this form out and list any parties who may have access to their child(ren)’s dental records.
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Silver Diamine Fluoride Consent