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Our SmileSketch Forms

Document with Pen

Please Download, Print, Fill Out, Sign and send
back to us at smilesketchvegas@gmail.com or bring with you at your first appointme

 THE FIRST 7 FORMS 
ARE REQUIRED FOR YOUR FIRST APPOINTMENT!

Thanks!

Call/Text  (702) 941-4148

Forms to download and fill out...

Form #1

Personal Info and  Welcome Info

Form #2

New Patient Information & Medical History

Form #3

Please fill out as much as possible, we will review this with you.

HIPPA Forms

Form #4

Dont forget to add a family member that you give permission for us to speak to about your oral health care.

Informed Consent to begin your exam

Form #5

This is a general informed consent so that we can conduct a complete exam and diagnosis with you.

Form #6

Electronic (Text/Email) Consent Form

This gives us permission and direction so we can stay in touch with you.

Are you Thinking Cosmetic Dentistry

Form #7

We love pictures and social media, we want your permission to take pictures first for our own records and then for social media posts.

Please fill out the contact form

Thanks for submitting!

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