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New Patient
Forms
You can help make your child’s first
visit to our office easy and fun. Explain that he/she
will sit in a special chair as we “count” all the teeth.
We may take pictures of his/her teeth and demonstrate
the proper way to brush. Your child should know that we
give presents. We designed our office to create a warm,
friendly atmosphere to make everyone comfortable.
 Please assist us in creating a positive experience for
your child by avoiding any negative language (“needle,”
“shot,” “drill,” “hurt,” etc.) that may scare your
child. If you are unsure of what to say, the adage “less
is more” holds true. Children are extremely sensitive to
the emotions of those around them so try not to convey
any of your own fears. If a pediatric dental office is a
new experience for you, you may be surprised at how well
your child reacts.
Despite
all your preparation, your child may still be
apprehensive of this new experience and he or she might
cry. Crying is a normal reaction to the unknown; do not
be upset or discouraged. Most children quickly learn to
cooperate, relax, and enjoy the visit to our office.
 Our
staff is trained to determine the most effective means
to make this visit an easy one for your child. For those
not ready for a full appointment, the first visit may be
one of meeting us and touring our office. We promise to
thoroughly explain every procedure to your child. This
method, known as Tell-Show-Do, proves to allay many
children’s fears.
For most children over the age of three, we perform a
full examination of the teeth and supporting structures.
Following a review of your child’s medical and dental
history, a prophylaxis (cleaning) will be completed. We
assess the occlusion (bite) and may suggest interceptive
orthodontics to minimize future treatment requirements.
Radiographs are important to detect decay as well as
assure that the unerupted teeth are developing properly.
Our conservative radiographic policy reduces your
child’s exposure, but x-rays do ensure a comprehensive
examination.
Following your child’s examination, we will discuss our
findings and any future treatment needs.
We love when Dr. Andrew counts our
teeth
Let's wash those beautiful teeth
Look at our cool sunglasses and new
toothbrushes
Cool Prizes: Stickers, Tattoos, and
Color-Changing Pencils!
Look at our full goodie bags!
New Patient Forms
To facilitate the ease of your first visit with us, we offer downloadable
forms; please click on the link below to view and print the forms. Complete
the information and mail the forms to our office prior to your
first visit.
HIPAA-Read Only
New Patient Forms
(Includes Medical History, Child's Registration, HIPAA, and Transfer of
Records)
To print the forms you will need Adobe Acrobat Reader. If
you do not have Adobe Acrobat, please
click
here to download it for free to
your computer.
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