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Patient Forms

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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 - Childsecured
  • Patient Form - Adultsecured

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*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.

Arthur Orthodontics

  • Glendale - 6320-A West Union Hills Dr., Suite 280, Glendale, AZ 85308 Phone: 623-362-1135
  • Desert Ridge - 20950 N. Tatum Blvd., Suite 280, Desert Ridge, AZ 85050 Phone: 480-505-3097

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