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Forms & Policy

Take a quick moment to go through our forms and policies before you come in for your appointment. The downloadable forms are available to you so that you may fill them out at your convenience. Call us if you have any questions. We are a resource for you.

New Patient Forms

If you would like to save some time on your first visit, download and complete the following forms from home.


-   New Patient Form   (PDF)

-   Kids Welcome Letter   (PDF)

-   Insurance Guidelines   (PDF)

-   Request for Release of Records/Radiographs  (PDF)

-   Financial Guidelines   (PDF)

-   Appointment Policy  (PDF)

-   Privacy Practices  (PDF)



-   Sunshine Coloring Sheet  (PDF)

Office Policies

Call the office to schedule an appointment for your child. Do not wait until your child complains of a toothache, but be proactive in the dental health of your child. Establish your child’s dental home after age one. Schedule regular appointments for your child’s cleaning, and if you cannot keep an appointment, we ask that you please notify our office at least 24 hours in advance.



Payment is due for professional dental service at the time that treatment is provided. Please see the office manager if you have insurance and/or you need help in filing an insurance claim.

    See our Finance & Insurance Page >

Our office kindly requests that you remain at the office while your child is being treated. Please bring only the child who is being treated; we have no one to watch out for other children while one child is in the treatment room. The supervision of your children is your responsibility.

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Providing Personalized, Gentle Care for your Child
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