Orthodontist Mesa AZ : Braces Mesa AZ : Invisalign Mesa AZ : Orthodontist Glendale AZ : Braces Glendale AZ : Invisalign Glendale AZ

480.636.9970 Request a Consultation

New Patient Forms

Click below for the appropriate new patient form.  Bring the completed form to your initial consultation so that we can help you in the most efficient way possible. 


English Adult Form       English Child Form

Spanish Adult Form      Spanish Child Form


English HIPAA Privacy Act Form

Spanish HIPPAA Privacy Act Form 

Our consultation days are designed to provide our patients with the overall practice experience, and will last longer than a normal visit.  We ask all patients to allocate at least (2) hours to complete the initial consultation visit.  Patients should be prepared to meet with the doctor for an examination, have X-rays taken, and consult with a financial adviser.  If you have orthodontic insurance, please bring your insurance card and provide a valid state issued ID.