New Patient Forms

If you or a family member are interested in becoming a new patient at Smith-Brauer Dentistry, please ckick on the links below and fill out the PDF’s right on your screen. Then click the submit button to email it back to us. If you would rather print the form out and fill it out manually, please download our Welcome Package and bring it to us during your first consultation. Right click each link and “Save As” to the desktop. Then open with Adobe Acrobat. If you don’t have the latest version of Acrobat you can download Acrobat Reader here. Once filled out, click on the submit button or save PDF and attach file to your web based email to send.

CLICK TO FILL OUT OUR NEW PATIENT FORMS

HIPPA Form

Adult New Patient Form

Child New Patient Form