Patient Forms

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You may access the following forms to assist us with your orthodontic care.

Online Forms

Please complete the following form, and click the “Submit” button at the bottom.

Printable Forms

Please download, print and complete the following form, and bring it to your appointment.


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*These forms require Adobe Acrobat Reader. Click the Adobe logo above 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.

***For Apple/Mac Users: You must use Adobe Acrobat Reader to submit the forms. To do so, simply right click on the form and save form. Open form in Acrobat Reader, fill out the form and submit.