Patient Forms

We'd like your first visit to our office to be quick and easy. Prior to the new exam appointment, please take a few moments to complete our on-line health history.

Click the link below to start.

https://orthoii-forms.com/custom/3144/healthhistory/KampasHealthHistory.aspx?custid=3144

-or- 

If you like ink and paper, here are our forms.

Please take a minute to print and fill out the patient information form before your first appointment:

• Patient Form (Child) PDF | DOC
• Patient Form (Adult) PDF | DOC
• Smile Club Certificate PDF
• Smile Club Program Guide PDF

Our School Shuttle requires that you fill out a few forms:

• Release and Consent to Transport PDF
• Daily Permission Form for the School  PDF

 

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