Patient Forms

Once you have made your child’s first appointment, please click on each of the

below links in order to download and print each form to bring with you to the

office. We look forward to meeting you and your family!

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If you have questions regarding or accessing our forms, e-mail us at info@kidsteethRus.com or call our main telephone number (508-337-3307).

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Med History Update (Necessary for each cleaning visit, every 6 months)

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Medical/Dental History Form (New patient form. Only needed for 1st time patients.)

Treatment Consent Form (Necessary for your child's 1st visit.)

HIPAA Acknowledgement Form (Necessary for your child's 1st visit.)

Behavioral Assessment Form (For special needs children.)