Patient Forms

FUNtastic Pediatric Dental offers our patient forms online so they can be completed in the convenience of your own device, before you arrive to our dental practice. One New Patient Registration and one Medical History page must be filled out per patient. All other forms may be filled out per family. 

Once submitted, our Team will make sure your information is secure:

Pediatric New Patient Registration (17 years and younger)

• New Patient Form
• Medical History
• Authorizations and Acknowledgements

Adult New Patient Registration (18 years and older)

• New Patient Form
• Medical History
• Authorizations and Acknowledgements

Teledentistry Form (Please fill out the teledentistry consent form prior to your virtual visit.)

• Teledentistry Form