The forms and documents below are available as PDF files for convenient download.  If you wish to reduce the wait time during your first visit, please download, print and complete the ‘New Patient Paper Work’ before bringing it into the office. You can also email completed forms to wborthodontics@gmail.com to help us go paperless.  Other necessary forms are also available below for download.  Thank you!

New Patient Paper Work PDF

New Patient Paper Work Printable Packet

COVID 19 Questions and AAOIC Informed Consent Form

A few reminders for your appointment:

  • Bring your valid photo ID
  • Please wear a mask (or scarf) covering your nose and mouth to your appointment and wear a mask at all times, unless being worked on by the orthodontist or dental assistant
  • Bring your referral, if applicable
  • Let us know if your current dental insurance will be expiring in the next 3 months
  • If you have two or more dental insurances, please bring all dental insurance cards to your appointment (or email them to wborthodontics@gmail.com)
  • If you’re unable to fill out your new patient paperwork ahead of time, please arrive to your appointment 15 minutes early

Questions about our forms?  Call (804) 454-1888