As a new patient to Smiles Restored you will be required to fill out the New Patient Forms. These forms can be downloaded from this page and opened using Adobe Reader©. If you do not have Adobe Reader© installed you can download it via the link provided below. 

Please click on the links below to download the New Patient Forms and they will open in your browser. If you want to save a copy of the form to your computer, please right-click on the link and select ‘Save target as…’.

Please print these forms, fill them out completely, and bring them to the office with you on your first visit. This will save you approximately 15 minutes during your first visit.


New Patient Form

Consent to be treated

Privacy Notice


Don’t have Adobe Reader©? It’s free and can be downloaded from Adobe by clicking on the link below.