New Patient Forms

Please complete the following forms to bring to your initial visit:

Health History Form (1 per child)
Account Information Form (1 per family)
Financial Policy Form (1 per family)
HIPPA Acknowledgement Form (1 per family)

For your records:
HIPPA Notice

Call us at 303.604.9500 for Lafayette or 303.702.9501 for Longmont with your questions for the Foothills Pediatric Dentistry Team or to schedule your child’s first appointment with us.