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Our SmileSketch Forms
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
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