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Patient Forms

Patient Forms

Our patient forms can be filled out electronically or by hand. Please bring your completed form to your first appointment.

Child Health History Form for our child, tween and teen patients View Child Form
Adult Health History Form for our patients 18 years and older View Adult Form

Completed forms can also be emailed to rereichardorthodontics@gmail.com. However, depending on your email provider, please be aware that your email to us may not be fully secure. By emailing us, you’re giving consent for us to communicate with you via email.