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

Pediatric Patient Forms


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 and complete the desired form, then bring it to your appointment.


*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.