Home
Meet Dr. Bender
What is a Pediatric Dentist
Our Goal
New Appointment Policy
Privacy Practice
Contact Us

Patient Forms


This page contains printable versions of our new patient & continuing patient forms.
We have taken the liberty of placing these forms on our web-site to give you the opportunity to fill them out at your own leisure, so that you don't have to do so while in our reception room.
Upon your first visit to our office, our staff will thoroughly review the information on the forms.
After which your child will be introduced to our dental team and invited to tour our office and become comfortable before the examination.
Continual Health Status Report
Health History Form
Questionair for Parents Form

Privacy Policy