Patient Forms for New York practice 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!



Adult Patient Forms




Child Patient Forms (Under 15)




Oral Cancer Screening

Appointment request
Need an appointment with a dentist in Hewlett ? Requesting an appointment at our Hewlett, NY family and cosmetic dental office 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