Thank you for making an appointment with Dr. Melissa's office for the dental care of your child/children.
Below, you will find the necessary paperwork needed for your first visit. Please print/fill out the forms and bring them to our office prior to your first visit. This will help keep your waiting time down, as well as our postage costs!
Alternatively, you may print the forms, fill them out, scan them and email them to us at info@melissapadgettdental.com.
- First Dental Visit Forms Packet (pdf)
- Additional Child Registration Forms (pdf) - if you are registering more than one child
If you have more than one child coming to the office, we will need a medical history and a registration form for each child. Please complete these forms for each additional child.
- Credit Card Automatic Payment Form (pdf)
Below is a copy of our Privacy Policy/HIPAA form. This form does not need to be returned to our office, but is available to you as a resource. This is the same policy in effect at all medical/dental offices.
Privacy Policy HIPAA Form (pdf) - updated 9/2013