Patient Forms

New Patient Forms:

Please download a new patient form below and complete it prior to your first appointment. You can email the forms to newpatient@smnortho.com, or you can print and bring them to your appointment. 

Please be aware that there is some level of risk that third parties may be able to read unencrypted electronic communication such as e-mail and fax. 

• New Patient form Children and Teens PDF
• New Patient form for Adults PDF
• Notice Of Privacy Practices PDF

Patient Instruction Handouts:

• Wearing Elastics (rubber bands)
• Retainer Instructions
• Headgear
• Separator Placement

 

Returning Patient Forms:

Please complete the online annual health history update, complete the authorized party form if it applies. 

• Annual Child Health History Form   
• Annual Adult Health History Form
• HIPPA Form
• Authorized Party Form

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