Click Here for New Patient Forms

Thank you for giving Dentistry 4 Kidz the opportunity to help with your child’s dental needs. At Dentistry 4 Kidz, our mission is to build quality relationships with a focus on prevention through education.

Your child should visit the dentist by his/her 1st birthday.  You can make the first visit to the dentist enjoyable and positive.  Your child should be informed of the visit and told that the dentist and his staff will explain all procedures and answer any questions.  The less to-do concerning the visit, the better. 

It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt.  The office makes a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

We strive to make each and every visit to our office a fun one!
 

New Patient Forms

In order to make your first visit to our office time efficient, please fill out the following forms according to the directions listed below.

Welcome Kids Sheet - Please fill out the entire Welcome form.

Financial & Insurance Policy - Please read carefully and sign.

Federal Requirements Regarding Patient Privacy (HIPPA) - READ ONLY
In order to comply with federal law regarding patient privacy, please read this document.

Patient Privacy Acknowledgement Form - Please read the above "Patient Privacy (HIPPA)" document and sign this acknowledgment.

NOTE:  You will need Adobe Acrobat Reader to open and print these forms.  If you do not have Adobe Acrobat Reader click on the logo icon below to download the free software to your computer. Please note that Adobe Acrobat Reader is preinstalled on most new computers.  

Please make sure that all information is completed and mailed back to our office before the appointment, or if time doesn't permit, simply bring the forms with you to your first visit. This will avoid delays or possible rescheduling of the initial visit.

Our staff is committed to helping our parents feel comfortable and worry free. Please call our office with any questions or concerns you might have. (940) 691-5027.

Thank you,
Dr. Bonner & Staff

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© Copyright 2002 Paul S. Bonner, D.D.S.
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