New patients

Your first appointment

We at Smile By Design want your first visit to go smoothly, and one way of doing this is by completing the forms found below. If you are unsure as to how to answer a question, please feel free to call us so we may assist you. If you are unable to complete the forms before your visit, please arrive early in order to fill them out at the office.

Please complete the following information. Be sure to bring your patient medical release and HIPAA acknowledgment forms to your first appointment. During your first visit, we will review the appointment cancellation policy and the image release form.

• Patient Medical Release
• Registration and Treatment
• HIPAA Consent Form
• Appointment Cancellation Policy
• Dental Treatment Consent Form

You will also need to provide the following upon your first visit with Smile By Design:

• Dental insurance card (If applicable)
• Identification such as a driver’s license, military ID, or state ID

We have compiled a list of accepted dental insurance providers at the following link:

• List of Accepted Insurance Providers