Patient Forms

s-bracesWhen scheduling your first time appointment, we ask you for a valid e-mail address. This is primarily used as a tool to communicate with you about future appointments, announcements, etc. However, for your first time appointment, it will also be used to send you electronic versions of our new patient forms. There will be no printing necessary, unless you cannot complete a microsoft word document on your computer. Be sure to e-mail your forms to reception@bracesbyashcraft.com once they are complete or bring the printed copy in with you for your first appointment.

You will receive an e-mail with electronic forms attached before your scheduled new patient appointment. If you do not have an e-mail address, or did not provide one when setting up your first time appointment, we have a paper version available upon check-in at the office. Please arrive approximately 10 minutes before your scheduled appointment time, and if needed, we will be happy to assist you with these. There is a link to the new patient forms here for your convenience as well.

Do you have an update on your insurance? If so, please click the link below and fill out our insurance update form. Once complete, you can e-mail it to reception@bracesbyashcraft.com or bring it to the office when you are close by.

Please complete this form if you wish to have your monthly bill automatically drawn from your credit card or debit card.

If you have Delta Dental Smiles as your orthodontic insurance plan, we must have this letter completed by your dentist BEFORE we can submit your records for orthodontic approval. Please get a copy of this letter to your dentist and have them return completed form to our office.

**We are committed to keeping your personal information secure.