New Patient Forms

Help us get to know your child! Please prepare for your first appointment by completing our new patient information forms. Download the forms to your computer to complete at home. Then bring them with you to your first appointment.

Canton Office

New Patient’s Form

Medical History English

Medical History Spanish

Patient Screening Form

Privacy Policy

East Cobb Office

New Patient’s Form

Medical History English

Medical History Spanish

Patient Screening Form

Privacy Policy

*Please submit completed Patient Screening form to info@niadentistry.com. Thank you!