Forms

Please feel free to print any of the documents we have available. Some files may take up to a few minutes to load on a 56K connection. All documents are in .pdf format, which you can view using the free Adobe Reader. Also, you can directly fill out the pdf forms using the typewriter tool to have all the information filled out before printing the form.

First Time?

If you are coming to the office for the first time, fill out the Patient Information Packet to save time.

Orthodontic patients also fill out Orthodontic Health Information

Need to Update Information?

If you need to update any information (and we recommend you do so to insure the best possible care), fill out the Patient Information and COVID-19 Packet

All Forms

English 中文 Other
Basic Forms
Patient Information Form Chinese Patient Information Form
Health History Form 健康記錄 Bệnh Sử (Vietnamese)
Patient Information and Health History Update Form
COVID-19 Screening Form COVID-19 Formulario de Cribado (Espanol)
HIPPA Consent Form (NEW!)
COVID-19 Safety Procedure 新冠病毒期間的安全措施和常規護理;
Special Forms
Toothache/Oral Pain Questionnaire (Bilingual) 牙痛/口腔疼痛問卷 (雙語)
Informed Consent for Radiographs (X-Rays)
Exam Form For Trauma Patients
Orthodontic Forms and Information
General Information and Office Policy for Orthodontic Patients
AAGO TMD Pain and Sleep Form
Retainer Information
Retention Consent Form

Additional Resources

Care for Your Temporary Filling and Crown
Notes on OSA (Obstructive Sleep Apnea)
Myofunctional Evaluation and Exercises
Myofunctional Evaluation and Exercises

References

Comprehensive Nonextraction Treatment for An Adult. Skeletal Class I, Severe Right Side Anterior Crossbite
Treatment of an Anterior Crossbite with Moderate Crowding March 2016 Case Report