You may access the following forms to assist us with your child’s dental care. Please complete the following forms requiring signatures and bring with you to your first scheduled visit.

Welcome to our office:

KPD Brochure

Patient Welcome Letter

HIPAA Laws:

HIPPA

Forms that require signatures:

KPD-HIPAA Policy and Procedures

Authorization Release of Dental Records

Medical History Update

Pediatric Medical History

Patient Registration

Or follow the links below to fill out the needed forms on your phone with no printing!

Updated paperwork for Returning patients HIPAA and Office Policies update

PLEASE NOTE PAPERWORK IS ONLY FOR THOSE WHO HAVE CALLED AND HAVE AN APPOINTMENT.

WE DO NOT OFFER ONLINE BOOKING AT OUR OFFICE.

ANY PAPERWORK FILLED OUT WITHOUT AN APPOINTMENT WILL BE DESTROYED.

If you would like to make an appointment please call: 207-942-0593