Your Account and Appointments

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Patient Forms

Please help us be prepared for your first appointment by completing this Medical/Dental History form. Print the appropriate form for the patient's age, fill it out, and bring it with you to our office.

Medical/Dental History for Patients Under 18 Years of Age:

Medical/Dental History for Adults:

If you're unable to read PDF files, you can download Acrobat Reader free from Adobe.


Home | Meet Dr. Powell | Meet Our Staff | Tour Our Office | What Braces Can Do
The Magic of Braces | Life with Braces | You and Dr. Powell | Services | FAQs
Kids Page | Interesting Links | Location & Contacts | Patient Care Video | Patient Forms

Your Account & Appointments