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New Patient Forms:

a picture of forms

All new patients must fill out a Medical and Dental History Form and a HIPAA Privacy Form. You can save yourself some time by completing these forms at home and bringing them with you to your initial appointment. If you have insurance coverage, please fill out the proper insurance form as well (either Child or Adult Insurance Form) so that we can confirm your orthodontic benefits.

These forms are in PDF (Portable Document Format) which requires a PDF reader (Adobe Acrobat or such) software. If you are unable to read these forms, you can download the free software from the Adobe website.

You can fill out the forms right in your browser (Explorer, Chrome, Safari, NOT Firefox) window . (Type the information right into the fields [blanks] and print.) Or you can simply print the forms from your browser window and fill them in by hand later.

Tip:

We will provide you with a CD copy of your CBCT X-rays at your visit if time permits. With the newest and most advanced 3D imaging available, we can give you the shareware software and your digital scan allowing you to view your 3D image at home. The ICAT FLX is the top Cone Beam CT machine on the market (and it's made locally!). Images produced by this X-ray machine are breathtaking and will allow us to better serve our patients' needs.

With this new technology we can see everything - root relationships, impactions, supernumerary teeth, airway, TMJ, and pathology - for the first time without distortion.

Please note: The ICAT has some of the lowest radiation dose settings on the market.


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