Patient Forms

Dentistry for Children isn’t just a dentist office. It’s a place children look forward to visiting and where parents are just as comfortable as the patients. We make sure healthy always comes with a big dose of happy. Dentistry for Children is Where Smiles Grow.

Stay Safe While You Wait:

We encourage all parents to remain in their car during their child’s appointment. However, if we feel it is necessary for you to accompany your child, one parent will be allowed back for the visit. Parents allowed back must maintain social distancing from other patients who may be present.

  • New Patient Forms

    To save a little time, you are welcome to print and complete the forms below and bring them to your first visit.

    Download
  • Privacy Notice

    This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

    Download
  • New Patient Agreement

    We are happy to have the pleasure of meeting your child’s dental needs. Please read carefully and sign the following new patient agreement.

    Download
  • Georgia Department of Public Health Form 3300

    Form 3300 is intended to make sure that every child in Georgia is screened for possible problems with their vision, hearing, teeth and nutrition. The earlier these problems are detected, the earlier parents can seek professional help for the child.

    Download
  • Formas para Pacientes Nuevos

    Para ahorrar un poco de tiempo, puede imprimir y completar los formularios siguientes y traerlos a su primera visita.

    Download
  • Acuerdo de Nuevo Paciente

    Gracias por darnos el placer de satisfacer las necesidades dentales de su niño(a). Por favor lea cuidadosamente y firme el siguiente acuerdo de nuevo paciente.

    Download
  • Aviso de Prácticas de Privacidad

    Este aviso describe como su información de salud puede ser usada y divulgada, y como
    usted puede acceder a esta información. Por favor lea cuidadosamente este aviso.

    Download

How Can We Help?