Patient Forms for Smiles by Design
Everyone here at Smiles by Design values your time as our patients. If you are new to our office please print and fill out the forms below, and bring them with you on your first visit. We look forward to seeing you!
INSURANCE AUTHORIZATION FORM
MEDICAL HISTORY INFORMATION
DENTAL HISTORY INFORMATION
NOTICE OF PRIVACY PRACTICES
ORAL CANCER SCREENING
Please print and fill out all forms before your appointment. If possible, please email to firstname.lastname@example.org