Patient Forms

We’ve compiled our most used patient forms here so that you can fill them out in the comfort of your home or office.


Request an Appointment

Welcome to our practice! Complete this form in its entirety and one of our team members will reach out to reserve an appointment.

Records Request

Thank you for choosing Southern Smiles! Has your child been seen at another dental practice? If so, this completed form will allow us to request all appropriate records prior to your child’s first visit.

Appointment Agreement

We’d love to see you and your smile. Click here to review our appointment agreement.