NEW PATIENT forms (electronic) - PLEASE COMPLETE ALL 4 FORMS
NEW PATIENT INFORMATION
Please complete the new patient information form. Click the link below.
MEDICALHISTORY/HISTORIAL MEDICO
Please complete this form prior to your initial exam. Just click on the link below, fill out the form, then press submit.
PRIVACY PRACTICES/AVISO DE PRÁCTICAS DE PRIVACIDAD
Please read our privacy practices (see below) and complete the form below prior to your initial exam. Just click these link to complete the form electronically.
INITIAL RECORDS (INFORMED CONSENT, PHOTO RELEASE, AND PATIENT CONTRACT*)
Please read the informed consent (see download below) and e-sign the form by clicking INFORMED CONSENT below. (*IF THE PATIENT IS UNDER 18 YEARS OF AGE, THE CONTRACT NEEDS TO BE SIGNED BY THE PATIENT AND THE PARENT).
REGISTROS DE ORTODONCIA (ELECTRONICA)-CONSENTIMIENTO INFORMADO, PHOTO RELEASE, Y CONTRATO DEL PACIEN
Lea el consentimiento informado de AAO (ver descarga a continuacion) y firme electrónicamente el documento a continuación (*SI EL PACIENTE ES MENOR DE 18 ANOS, EL CONTRATO DEBE SER FIRMADO POR EL PACIENTE Y EL PADRE).