Cover-Patient-Forms

Patient Forms

Below, you will find all of the forms needed for your child’s initial visit. Please complete all forms, don’t forget to bring their Dental Insurance Card to the appointment.


Please complete for each new patient.


(Coming Soon)



Please complete and bring this form if your child will be attending his/her dental visit at Little House of Smiles, Children’s Dentistry with someone other than a parent/legal guardian. Use a separate form for each child.


(Coming Soon)