Patient Forms

New COVID-19 Reopening Office Protocol 

Before coming to our office, please read our new Office Protocol and Patient Screening Form.

• COVID-19 Reopening Office Protocol 

• Patient Screening Form

New Patient Forms

Please call the office to schedule an appointment. Once the appointment is scheduled, we will send you an email with a link to give you access to your portal. In the portal it will give you access to your child's account.

Power Of Attorney

You will need to print and notarized this form to enable someone you trust to make medical decisions on behalf of your children. Before you fill it out, keep in mind that it is a big responsibility to give someone. There are some things to ask yourself: Does the person live close by? Have you talked with them in-depth about this responsibility? Before deciding who you would like to assume this role, make sure you discuss all pertinent information with them.

• Power of Attorney Form (PDF)

Adult Consent

If you need your child to be brought by someone different than you to their appointment, please make sure you fill out this form and sign it so we can proceed with their cleaning or treatment. This person can be inform of what it's being done to your children but they cannot make decisions about your children's treatment.

• Adult Consent Form (PDF)

If you're unable to open PDF files, you can get Adobe Reader® for free.