New Patient FormS

To ensure the most efficient use of your consultation at the office, we ask you fill out all your new patient forms (3 forms) before your appointment.

These three forms are available online and can be conveniently completed on your mobile device or computer for electronic submission.

1. New Patient Registration Form

Please allow yourself about 10-20 minutes to complete this form, which includes questions regarding patient information, medical and dental history, and dental insurance (if applicable).

You can save this form while in progress (requires creating a login).

**If you require Spanish translation, please select the "Spanish" Language when start the form.

2. Informed Consent Form

Please allow yourself about 5-10 minutes to review the Informed Consent form. Your consent is required in order to allow us to take any necessary x-ray and/or photos during your consultation.

3. HIPAA and Photo Authorization Form

Please allow yourself about 2-5 minutes to review the HIPPA and Photo Authorization form. This form includes information about our Privacy Practice policies to ensure the protection of the patient health information.

Kind Orthodontics | Orthodontic Services Available to Dublin, California

2. SPANISH Consentimiento Informado