New Patient Form (Child)
To be completed by the parent/guardian of the child seeking treatment. If you are an adult seeking treatment for yourself, please use the Adult Form. Please complete at least 24 hours prior to your appointment with us so that we may better serve you.
This is a secure site that protects your information.
You can also simply come to the office and we will supply you with a form to fill out.
Thank you for choosing Bentley Orthodontics! We are excited to have you in our family!
New Patient Form (Adult)
To be completed by the adult seeking treatment. If you are the parent/guardian of a patient seeking treatment please use the Child Form. Please complete at least 24 hours prior to your appointment with us so that we may better serve you.
This is a secure site that protects your information.
You can also simply come to the office and we will supply you with a form to fill out.
Thank you for choosing Bentley Orthodontics! We look forward to meeting you!
