Patient Information

First Visit
FAQ
Common Teeth Problems
Emergency Info
Patient Forms

PATIENT FORMS

For your convenience, you may download, print and fill out the following forms and bring them to your next appointment:

• Adult New Patient Form
• Child New Patient Form
• HIPAA Privacy Policy

Transfers Records Forms

If you are transferring from another orthodontic practice, you may also download, print and fax this form to my office at (678) 401-6263 and we will request your records. There is a generic form if you are transferring from another orthodontic practice and a specific form if you are transferring from my previous practice.

• Record Request Form Generic
• Record Request Form Specific

These forms require Adobe Acrobat Reader.
If you do not have Adobe Acrobat Reader, click the Adobe logo to download.

Ultimately, orthodontics does more than make a pretty smile – it creates a healthier you.