New Orthodontic Patient Forms
Save Time At Your First Visit
Please fill out our new patient form at your own convienence and bring it to our office on your first visit.
Start Braces At Your First Visit
Please have your dentist fill out this form to ensure that you are cavity free so we can start your braces treatment same day!
New Orthodontic Patient Forms
Welcome to Textbook Orthodontics! We’re so excited to meet you and help you begin your journey to a confident, healthy smile. Whether you're here for braces, clear aligners, or a consultation, we want your first visit to be smooth, stress-free, and enjoyable.
To make your check-in process quick and easy, we provide all our New Patient Forms online. These forms are essential for gathering your health history, contact information, and insurance details so we can provide the best personalized care from the moment you walk in.
Why Do I Need to Fill Out New Patient Forms?
Orthodontic treatment is about more than just straight teeth—it’s about your overall health. These forms give us important background information, such as:
Medical and dental history
Allergies or medications
Previous dental treatments
Concerns or goals for your smile
Knowing this information helps us tailor your treatment plan specifically for you or your child, ensuring that it’s safe, effective, and aligned with your long-term health goals.
What Forms Will I Need to Complete?
When you schedule your first visit, you’ll receive a link to complete the following forms digitally:
Patient Information Form – Basic contact info, birthdate, and how you heard about us.
Health History Questionnaire – Includes medical background, allergies, medications, and relevant dental history.
HIPAA Consent Form – This form ensures your privacy and explains how your health information is protected.
Insurance Information (if applicable) – Helps us verify your benefits before your visit.
Informed Consent for Orthodontic Records – Grants permission for us to take necessary X-rays, photos, and digital scans.
All forms are mobile-friendly and can be completed on a smartphone, tablet, or computer—no printing required!
Save Time at Your First Appointment
Completing your new patient forms ahead of time helps us stay on schedule and gives you more one-on-one time with Dr. Nourian and our team. If you’re unable to fill out the forms in advance, no problem! Just arrive 10–15 minutes early and we’ll provide you with a tablet in-office to complete them.
Need Help?
We understand that paperwork can be a little overwhelming—especially if you're filling it out for your child or multiple family members. If you have any questions while filling out your forms, feel free to call or text us. Our friendly front desk team is always happy to help guide you through the process.