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Patient forms

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New Patients Individual forms

Click below links to fill the forms online
First time patients need to complete this set for each child in family.

Existing patients coming to appointment

Click below links to fill the forms online
In case the webforms do not work for you. Click the links below copy of PDF file. You can print, fill and bring them along to the appointment.
If a Parent or Legal Guardian is not going to accompany the child, please print below form, sign, date, witness it and send along with caregiver to clinic on day of appointment.

Click links below for copies of our policies, acknowledgments and consents

  1. Notice of Privacy Practices
  2. Notice of Non-discrimination
  3. Financial & Office Policies
  4. Billing of Non-covered services 
  5. Informed consent for treatment
  6. Image Release form
  7. Please read and understand the pre & post op instructions for moderate sedation.