New Patient Forms

Please click the link below to connect to our secure New Patient Health History submission form. Please take a few moments to fill out this online form completely prior to your initial exam appointment.

Once completed, please click 'Submit' at the bottom of the form and it will be uploaded to our secure patient management system. This will save you much time having to fill out a paper form in our office at your first visit.

Thank you and we look forward to meeting with you soon!

Health History

HIPPA Privacy Notice

Patient Acknowledgement Form

WHAT SETS
US APART

We are dedicated to providing exceptional care to you and your family. Our primary focus is assessing your needs, ensuring your comfort, and improving upon your beautiful smile!

YOUR FIRST
VISIT

We are always excited about meeting new patients! Your initial appointment will consist of a thorough examination and a discussion of potential treatment options.

SCHEDULE
YOUR
APPOINTMENT

If you believe you or your child could benefit from orthodontic treatment, schedule an appointment today and see what a difference a beautiful healthy smile can make!

Office Locations

2445 Tampa Rd, Ste A, Palm Harbor, FL 34683

(727) 781-7475

1803 Short Branch Dr, Ste 102, Trinity, FL 34655

(727) 376-2770