COVID-19 Treatment Consent Form

Waiver must be signed before recieving treatment at Kids Dental Specialty

 

Download Treatment Form

New Patient Forms & Patient Survey

(Complete Both New Patient Forms & Patient Survey)

If your child is a new patient to our office please fill out the following forms so we can expedite your first visit. Completing these forms prior will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office (909) 333-7457 if you have any questions at all.

New Patient Forms

New Patient Form

Patient Survey

Patient Survey

Additional Forms for your reference: (Printing Optional)

This web site uses files in Adobe Acrobat Portable Document Format Adobe Acrobat PDF (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.