Patient Forms

Please take a minute to fill out the first 4 forms below before your first appointment.  Print them out or, if possible, please download, complete, save to your computer then email them to

  • Patient Information Form PDF
  • Patient Medical History Form PDF
  • Acknowledgement of Receipt of Privacy Practices PDF
  • Notice of Privacy Practices (Reference only; no need to print) PDF


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PATIENT education materials

  • ​Food for Orthodontic Thought - No No List PDF
  • Brushing Technique PDF