Patient Forms
We understand it is an inconvenience to fill out paperwork every six months, but it is required so we can recommend the best treatment approach based on each patient’s current health status. Health status and use of medications can change frequently.
It is important for our office to be informed of such changes so we can provide optimal care. We take a personal interest in your health and giving our attention to this very important part of comprehensive patient care. After all, your oral health is connected to overall physical health.
For your convenience, we have provided patient forms below. If you are a new patient, you can complete these forms and turn them in to the office at your child’s first visit, to save on wait time at the office.
Save trees and time in-office by clicking the links below to fill out and submit patient paperwork online. Or, click any .PDF link to download and print blank patient forms that you can fill out and bring with you to upcoming appointments.
We look forward to seeing you!
New Patient Forms
- New Patient Online Form
- New Multi-Patient Online Form
- New Patient Printable Form - English
- New Multi-Patient Printable Form - English
- New Patient Printable Form - Spanish
- New Multi-Patient Printable Form - Spanish
2020-2021 School Calendars & Test/Assessment Schedules
- Gwinnett County School Year Calendar
- Gwinnett County Public Schools Testing/Assessment Calendar
- Hall County Schools Calendar
- Hall County School District Testing Calendar
- Gainesville City School System Student/Teacher Calendar
- Barrow County School System Student Calendar
- DeKalb County School District Calendar
Health History Update Forms
- Health History Update Online Form
- Health History Update Printable Form - English
- Multi-Patient Health History Update Printable Form - English
- Additional Family Member Health History Update Printable Form - English
- Health History Update Printable Form - Spanish
- Multi-Patient Health History Update Printable Form - Spanish
- Additional Family Member Health History Update Printable Form - Spanish
Additional Forms
- Caregiver Authorization Online Form
- Patient Authorization To Release Information - Online Form - English
- Patient Authorization To Release Information - Online Form - Spanish
- Patient Request For Information - Online Form - English
- Patient Request For Information - Online Form - Spanish
- Appointment and Payment Agreement Online Form
- Attestation of Pregnancy Printable Form
- Patient Authorization To Release Information Printable Form
- Patient Request For Information Printable Form
- Caregiver Authorization Form Printable Form English
- Caregiver Authorization Form Printable Form Spanish
- Appointment and Payment Agreement Printable Form English
- Appointment and Payment Agreement Printable Form Spanish
- Georgia Department of Public Health Form 3300 Printable Form