New Patient Forms
We understand that you have other items on your agenda for the day and want to help expedite your visit with us. To shorten your wait time, print and complete the forms below and bring them with you to your first appointment.

The Jacaranda Smiles team is excited to have you join our family!

If you are bringing in a dependent for either an orthodontic or pediatric dentist appointment, please fill out the child orthodontic and/or pediatric form below.

Child orthoDONTIC and/or pediatric forms

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If you are over age 18 or are using your own insurance and are seeing us for either an orthodontic or pediatric dentist appointment, please fill out the adult orthodontic and/or pediatric form below.

Adult OrthoDONTIC AND/OR PEDIATRIC forms

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