785-856-5600 info@wegrowsmiles.com

Patient Forms

Please take a minute to print and complete all three forms below:  the New Patient Registration Form, the Health History Form and the Financial Policy and Notice of Privacy Practices.  Completing all three of 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 before your appointment.  Just make sure to arrive a few minutes early!

HIPAA Privacy Rights

Kids Dentist of Lawrence LLC is a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Kids Dentist of Lawrence 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.