785-856-5600 info@wegrowsmiles.com

Patient Forms

Please take a minute to print and complete the forms below:  the Registration Form, the Health Form and the Financial Policy & Notice of Privacy Practices.  Completing these forms will help expedite your visit to Growing Smiles.  If you are unable to complete before the appointment, no worries – we will provide these forms to you at the office.  Just please make sure to arrive a few minutes early!

HIPAA Privacy Rights

Growing Smiles LLC is a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Growing Smiles LLC maintains a separate Notice of Privacy Practices (HIPAA) as required by law, which applies to all protected personal health information (PHI) that is collected from individuals. Please view and / or download our statement in English or Spanish.