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Patient Forms

Thank you for joining our dental family. We look forward to meeting you and your child. Please fill out the following forms prior to your scheduled appointment.

New Patient Forms
Health & Social History Form
Personal Information Form
HIPPA & Authorization to Release Information Form
Financial Policies & BA-CA Policies

Other Forms
Child Health and Personal History Update Form
Adult Health and Personal History Update Form
Parental Consent to Treat Over Age 18 Form
X-Ray Release Form

If you need any information or have any concerns, do not hesitate to call us.

Thank you for choosing Smiles for the Future to help with your children’s health, growth and comfort.

Click here for directions to the office.