Patient Forms

New Patients: Save time at the orthodontist and fill out your health history information online! Please take a minute to fill out the online patient information form below. We will have your information when you arrive for your first appointment which will help us serve you better.

 

Highlight web address, right click, select go to,  OR  copy/paste into browser.

  • Child New Patient Form:  https://securehealthform.com/mconsentemr/webform/elkgro998ca&formid=NDUyOA==  
  • Adult New Patient Form https://securehealthform.com/mconsentemr/webform/elkgro998ca&formid=NDUyOA==
  • Hipaa Notice Form - All Patients fill out this form  https://securehealthform.com/mconsentemr/webform/elkgro998ca&formid=NDQ2OQ==

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Name:
Elk Grove
Orthodontics
facebook name elk grove orthodontics