The following items are¬†only available to¬†customers of If you aren’t a current customer, you can sign-up online at our website packages page.

We offer several options for placement of new patient forms on your website. You may send us your own form or choose from one of the options below. We also offer patient survey, transfer of records and appointment request forms which can be viewed in our Pre-Developed Content section.

Pre-Developed New Patient Form
(Included for free in all website packages)
Use’s pre-developed form with your own heading & logo. Money-saver for offices that currently purchase their form from another company or for new offices that don’t yet have a health form. This form is printed by your patient, completed and mailed or faxed to you in advance or brought in at their first visit.
New Patient Form Sample

Get this form in a typeable format for only $50 more!

Pre-Developed New Patient Form (Spanish) – $125 One Time Fee
The spanish version of the pre-developed new patient form. If you have spanish-speaking parents then this would be a great addition to your regular new patient form.
Spanish New Patient Form Sample

Get this form typeable for only $50 more!

Pre-Developed Typeable New Patient Form – $50 One Time Fee
This is the same Pre-Developed Form as above; however, your patient can complete it (type it) online then print it and bring it to your office. This is convenient for patients that prefer typing instead of writing and it allows the dentist and staff to read the content easier.
Typeable New Patient Form Sample
Online New Patient Form – $175 per year
This is the Online version of Dentists4kids’s Pre-Developed Form as shown above. Your patient can complete the form online and submit it to a secured server for your easy, safe, immediate access. No need to wait until the patient comes in to view their history or insurance information. You will be provided online access to your forms for viewing, printing or editing. Your forms can be customized easily by you through your own control panel AND you have the option of creating additional forms for no additional cost (there is a one time placement fee of $25 to insert each form into your website).
Online New Patient Form Sample
Convert Your Form to a Typeable Format – $75
If you want to offer an extra convenience for your patients, consider a typeable form to place on your website! We’ll take your existing forms and convert them to be typeable for $75 per form. You can use this to have your patients download from your website and print it off to be ready to go when they arrive!

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