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TO THE ORTHODONTIST We would like to welcome you and your child to our office. Our goal is to make every child's visit pleasant and educational. We strive to teach good oral care that will enable
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Fill in each section of the form accurately and neatly. Use black or blue ink and avoid any corrections or cross-outs.
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Provide all the necessary documentation or attachments as specified in the form.
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Sign and date the form where required.
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Submit the completed form to the orthodontist's office either in person, by mail, or through their designated online platform.
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Patients who are visiting an orthodontist for the first time or switching to a new orthodontist may be required to complete the form.
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Parents or guardians filling out the form on behalf of their children who require orthodontic treatment.
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Individuals seeking orthodontic services for cosmetic reasons or to correct dental misalignment.
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