Patient Forms
For your convenience, you may download, print and fill out the following forms and bring them to your next appointment:
• New Patient Form (Adult)
• New Patient Form (Child)
• HIPAA Patient Acknowledgment and Consent
• Informed Consent
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.
These forms require Adobe Acrobat Reader.
If you do not have Adobe Acrobat Reader, click the Adobe logo to download.
