Patient Forms



If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

Print & Complete All Forms Prior To First Office Visit

New Patient Registration (Adult)

New Patient Registration (Child)

Financial Policy/Notice of Privacy Practices

Notice of HIPAA

Smiles N Braces Family Dental
3380 Blackhawk Plaza Circle, Suite 210
Danville, CA 94506
Phone: 925-317-6308
Office Hours

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