New Patients

Patient Registration Form

Medical Health History Form

Financial Agreement

HIPAA Acknowledgment

At Smileworld Family Dental, your first appointment includes a thorough exam and gathering any information that our dentist must be aware of in order to provide care specifically to your oral health. We understand that all patients are different and require individualized care. 

Our Practice's Mission:

To fulfill our mission of providing quality dental care to you and your family, we are committed to:
  • Staying up to date with latest techniques and equipment.
  • Ensuring a comfortable, relaxing environment.
  • Exceeding your expectations with our professionalism.

What Every Patient Can Expect

At our practice, every patient can expect to be treated with prompt service at their specified appointment time. Our patients can also look forward to a comfortable experience. We understand that visiting a new dentist can be stressful, which is why our practice works to actively to accommodate all patients and alleviate any fears they may have about a new dentist or dentistry treatments. Familiarizing yourself with our practice, services, and our dentist is a great first step to creating a long term and comfortable experience with dentistry.

Other Forms
Local Anesthetic Consent
Filling Consent
Crown/Bridge Consent
Scaling and Root Planing (Deep Cleaning) Consent
Extraction Consent
Sealant Consent
COVID-19 Emergency Visit Consent
COVID-19 Screening Form
Authorization to release dental records