Please fill out and submit the appropriate form, as well as the following x-rays and insurance information, prior to your appointment with us.
- Any panoramic X-ray taken within the past six months.
- If you have orthodontic insurance, bring your insurance card. By providing this information at the first visit, we will be able to give you an estimate of your costs.
- Patient Form - Child

- Patient Form - Adult

*These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo to download.
**We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.