Patient Forms for New York practice Smiles by Design

For the convenience of our patients, we've added the patient forms for our Hewlett location to our website. Simply print these forms and fill them out in the comfort of your own home. When you arrive to your appointment, you'll only have to hand in your forms and wait!


If you have any questions about the forms below, call our Hewlett location at (516) 239-6204.



Adult Patient Forms

Appointment request
Requesting an appointment at Smiles By Design is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with us today!
Patient Name*
Phone Number*
Email Address
Are you a current patient?
Best time(s) to call?
Choose Location:
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments