Patient Forms - Periago Orthodontics

Free Consult

Save Time at Your First Visit

Please download these forms and bring them with you to your first visit to keep your appointment running on time.

English

Adult Health History Form Child Health History Form Tell Us About You Electronic Payment Authorization COVID-19 Screening Questionnaire AAOIC Supplemental Informed Consent

Spanish

Formulario de antecedentes médicos para pacientes adultos Formulario de antecedentes médicos para pacientes menores de 18 año

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