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Patient Registration Information

You may pre-register with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Consent Form

Please click the below button to download your health history form. This form is for the doctors prior to your appointment to ensure we cover all areas of your health prior to your visit. We want you to meet all appointment guidelines to ensure you are well prepared for your visit with Pristine Pediatric Dentistry.

Children's Dental & Medical Health History Form

Please click the below button to download your Children’s Dental & Medical Firmness Form. This form is for the doctors prior to your appointment to ensure we cover all areas of your health prior to your visit. We want you to meet all appointment guidelines to ensure you are well prepared for your visit with Pristine Pediatric Dentistry.