First

Visit

Thank you for selecting our office to serve your dental needs. Our entire team is dedicated to providing the highest quality orthodontic care and service to our patients. On your consultation visit we will take two complimentary x-rays. Dr. Casellas will examine the patient’s mouth and x-rays. He will then discuss an orthodontic treatment with you and your parent, if needed. You will then meet with the financial adviser and discuss your treatment fee, estimated insurance payments and your payment options. We will also answer any questions you may have at this time. If you would like, you can take advantage of the records discount and schedule you next appointment for initial treatment. We look forward to meeting you and your family.

• New Patient Form (Adult)
• New Patient Form (Child)
• Acknowledgement of Receipt of Notice of Privacy Practices
• Consent For Use and Disclosure of Health Information

The forms require Adobe Acrobat to open. If you don’t have it on your system already, please click on the link below for free download from Adobe site.