Affiliated Pediatric Dentistry & Orthodontics Provides Care To Patients of All Ages In The Scottsdale, Paradise Valley, & North Phoenix Area. Call Today!

Orthodontic Patient Forms

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Online Forms

These links will direct you to a secure server where you may complete your Health History form online.

Child (17 and under) Health History Form
 
Adult (18 and over) Health History Form
 

Printable Forms

 You may access the following forms to assist us with your care. Please print the following forms, fill them out, and bring them with you to your appointment.


*These forms may require Adobe Acrobat Reader. Click the Adobe logo above to download.
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**We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.