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Patient Information Form

Fill out your paperwork ahead of time to save time when you visit our office.

Patient Information Form

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Automatic Payment Form

Notice of Privacy Practices

Please review this notice describing how medical information about you may be used and disclosed and how you can get access to this information.

HIPAA Privacy Practices

Braces Removal Consent

This consent is for braces removal.

Braces Removal Consent

Phase 1 Braces Removal Consent

This consent is for younger children in their first of two phase treatment.

Phase 1 Braces Removal Consent

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One Time Payment Form
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