Forms

Playhouse Dental has made the transition to a chartless system! This allows us to provide you with more efficient and eco-friendly practice of care. While paper charts have become obsolete, the information you can provide us about yourself is not.

Please find below important new patient forms that we will ask you to fill out prior to or during your first visit.

• Registration Form
• Medical History
• HIPAA  Background and Acknowledgment Form
• Late Arrival and Missed Appointment Policy
• Nitrous Oxide Informed Consent

For your privacy and security, our web forms are encrypted using HTTPS over SSL.  If you prefer to complete these forms at our office, please arrive at least 15 minutes early.  If technology isn’t your friend, you can reach us by phone (BEFORE your child’s appointment) and we will work with you to complete the essential forms…. whatever it takes!

For our referring providers:

• Referral to Playhouse Dental

Other forms that parents may find useful:

• MEDICAL HISTORY UPDATE (for recare appointments)
• Clinic Post Op Instructions
• Dear Parents… Don’t Worry!
• Treatment Options
• Palatal Expander Instructions
• Flossing Instructions
• Tooth Brushing Chart
• Thumb Sucking Chart
• Dental Surgery Post Op