Patient Forms

As a new or existing patient with us at Wright Smiles Pediatric Dentistry, you will at times have to fill out forms when you arrive to help us keep our records up to date. You can expedite the process if you wish by downloading the forms ahead of time and filling them out before you come into the office. This page contains links to downloadable versions of the forms that will most commonly be needed.

New Patient

Please download, print, and fill out the New Patient Information form.

Returning Patient

If you are a returning patient and it's been more then a year or your information has changed please complete this form electronically:
Current Patient Chart Update

General Office Forms

• New Patient Information
• Current Patient Chart Update (Complete Electronically)
• Cleaning Consent
• Office Policy**
• HIPAA Notice of Privacy Practices

IV Sedation

• Complete Package

Oral Sedation Forms

• Oral Sedation Information

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