Call our office today to schedule your child's appointment!

Patient Forms

Please click on the links below to download and print each registration form. Please complete all the forms prior to your child's appointment and bring them with your child's insurance card to the appointment. If you are unable to complete the forms prior to your child's visit, please plan to arrive 10-15 minutes early so that you can complete them in our office.

Dr. Jamshidi sitting in office

New Patient Form

New Patient Questionnaire

Office Policies Form

Notice of Privacy Practices Form

Parent/Guardian Consent Form

Laser Frenectomy Forms

Frenectomy Infant Pre-Op Assessment

Frenectomy Infant Post-Op Assessment

Frenectomy Child Pre-Op Assessment

Frenectomy Child Post-Op Assessment

Staff Member and Patient and Guardian

Back to Patient Info