Forms

Patient Forms

For new patients or patients needing to update their information please fill out the Welcome Form, Medical History Form, Insurance form, and Covid-19 Form using the Adobe Reader when needed. If this is not possible please print out to fill and then and email to info@mybraces.com or fax to (707) 643-8759.

• Welcome Form
• Medical History Form
• Insurance Form
• COVID-19 Form

Referring Doctor Form

For referring dentists please fill out Doctor Referral Form using Adobe Reader. If this is not possible please print out to fill and then email to info@mybraces.com or fax to (707) 643-8759.

• Doctor Referral Form

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*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.