Save time and get a head start on your child’s dental visit!
Below you will find our required forms and agreements – all included in one easy file. Please print the PDF document, complete the forms, and bring all of the paperwork with you to your appointment.
- Patient Information
- Health History Form
- Office Policies
- HIPAA Notice
- Payment Agreement
We now offer an in house insurance membership plan for our families that do not have coverage by insurance. It is called Brecksville Kids Membership. For a monthly fee, parents can enjoy knowing that their children will receive cleanings, x-rays, exams, fluoride, emergency exams and a significant discount on any dental treatment needed. Inquire at your child’s next appointment!
