Patient Forms

Dentistry for Children isn’t just a dentist office. It’s a place children look forward to visiting and where parents are just as comfortable as the patients. We make sure healthy always comes with a big dose of happy. Dentistry for Children is Where Smiles Grow.

Stay Safe While You Wait:

We encourage all parents to remain in their car during their child’s appointment. However, if we feel it is necessary for you to accompany your child, one parent will be allowed back for the visit. Parents allowed back must maintain social distancing from other patients who may be present.

  • Privacy Notice

    This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

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  • New Patient Agreement

    We are happy to have the pleasure of meeting your child’s dental needs. Please read carefully and sign the following new patient agreement.

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  • Georgia Department of Public Health Form 3300

    Whether your child is starting kindergarten, going to a Georgia public school for the first time, or you just moved to the state, you’ll need to get your child’s Form 3300 completed. All new students need to have a vision, hearing, dental, and nutrition screening before heading to school.

    If you need to complete Form 3300, we’re here to help! We’ll perform your child’s dental health exam, fill out the form, and sign off on the dental screening portion.

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  • Acuerdo de Nuevo Paciente

    Gracias por darnos el placer de satisfacer las necesidades dentales de su niño(a). Por favor lea cuidadosamente y firme el siguiente acuerdo de nuevo paciente.

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  • Aviso de Prácticas de Privacidad

    Este aviso describe como su información de salud puede ser usada y divulgada, y como
    usted puede acceder a esta información. Por favor lea cuidadosamente este aviso.

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