Patient 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.