ALL NEW PATIENT FORMS AND 6 MONTH REVIEW FORMS WILL COME TO YOU VIA E-MAIL. OUR OFFICE IS CHARTLESS, SO THE PAPER FORMS ARE ONLY FOR CERTAIN CIRCUMSTANCES.
Please check your e-mail for the electronic new patient forms, if we already have a scheduled an appointment for your child.
The e-mail will come from Carestream Dental. It will contain several pre-populated forms that will require updating prior to clicking on the "submit" button. You may need to look through your junk and/or trash e-mails for the new patient e-mail from Carestream Dental. To ensure delivery to your inbox, please add eForms@carestream.com to your address book. Please call our office if you have any questions about accessing /using the e-forms.
If you DO NOT have access to e-mail:
Please help us by downloading and completing the forms below. Please fill out the forms in blue ink, if possible. You should bring these forms to your first visit as this will help expedite the check-in process. Please arrive 15 minutes prior to your child's appointment time so we can be sure all your paperwork is in order. Also, please bring your dental insurance card(s).
- Welcome Form
- HIPAA Notice of Privacy Practices
- HIPAA Signature form
- Patient Medical History Form
- Pediatric Dentistry Dental Questionnaire
**These forms require Adobe Acrobat Reader. If you do not have Adobe Reader already installed on your computer, click the Adobe logo above to download.
**For Apple/Mac Users: You must use Adobe Acrobat Reader. To do so, simply right click on the form and save form. Open form in Acrobat Reader and fill out the form. Remember to bring the paper forms with you for your first visit.