Pediatric Dentistry Forms
Below, you will find all of the forms needed for your child’s initial visit. Please print and complete all forms, and bring to your child’s first appointment with us at the The Brush Stop Pediatric Dentistry and Orthodontics.
Note: If bringing multiple children in for their initial visit, please print separate medical histories for each child. All other paperwork can be completed once.
Please find the following forms available in a PDF format to download :
- Medical History and Office Policies forms
- Consent for Initial Visit Form
- HIPAA Notice of Privacy Form
- Photography Release Form
If you’re unable to read PDF files, you can download Acrobat Reader free from Adobe. [Download Acrobat Reader]