Please take a moment to download and fill out our New Patient Information Packet.  We ask that you arrive 15 minutes prior to your appointment time with completed paperwork.  Young and Polite Children’s Dentistry strives to stay on time to provide great customer service to all of our patients.  We thank you for helping our team serve you in a timely manner.

Health Information Release Form

Health Information Release Form
Health Information Release FormHealth Information Release Form

Notice of Privacy Request Form

Notice of Privacy Request Form
Notice of Privacy Request FormNotice of Privacy Request Form

New Patient Forms

New Patient Forms
New Patient FormsNew Patient Forms

Release of Records

Release of Records
Release of RecordsRelease of Records

Friends and Family

Friends and Family
Friends and FamilyFriends and Family