kids need a kids’ dentist
Smith Pediatric Dentistry
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Forms

Forms

Click on the Links below to Download Forms


New Patient Forms

Welcome
Medical History
Patient Information
Acknowledgment of Privacy Practice
Notice of Privacy Practices

Others

Pre-Sedation instruction

(Note: These documents require Adobe Acrobat Reader)

  • Kids Need a Kids' Dentist

    148 South 1100 East
    American Fork, Ut 84003

    801.756.6048
  • Forms

    • Acknowledgement of Privacy Practice
    • Medical History
    • Notice of Privacy Practices
    • Patient Information
    • Pre-Sedation Instruction
    • Welcome
© Smith Pediatric Dentistry. All Rights Reserved.
www.smithpediatricdentistry.com

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