PATIENT INFO & FORMS
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Forms & Patient information to help you prepare for your visit
Prior to your appointment with Pediatric Dentistry & Orthodontics of Chattanooga, we’ve provided patient information and prepared all the patient forms you’ll need in a digital format so you can fill them out before you arrive! All files can be filled out and submitted online.
If you are unable to open the following PDF files, make sure you have an application that allows you to open and edit PDFs such as Adobe Reader! Adobe Reader is free to download and will allow you to view, sign, comment on and share PDF documents for free. If you are still unable to open them, you can fill them out in the office, our goal is to make patient information as accessible as possible to you and your family!
You’ll find all the patient information and forms you’ll need below!
Pediatric Dentistry Forms
Digital Medical History Forms: Below are the links for our Digital Health History Forms. Please click on the link that your child’s appointment is scheduled at. This will speed up your check in process.
Orthodontic Patient Forms
If you have any questions about scheduling an appointment or completing any forms, please contact your Pediatric Dentistry & Orthodontics of Chattanooga office location. We look forward to helping your family achieve and maintain a beautiful, healthy smile.
Pediatric Dentistry & Orthodontics of Chattanooga allows our patients the opportunity to pay their bills online! Pediatric dentistry patients will receive a link via text when we send out your statement. Orthodontic patients, please follow the link below and log into your account. If you do not have an account, don’t worry! The setup process takes under two minutes to complete.
Insurance Information
Our office will file most insurances. Please note we are only a participating provider with the following insurance companies. We recommend that you contact your insurance prior to your child’s visit to verify coverage if you only wish to see a preferred provider. We do not file secondary insurance.
