PATIENT FORMS

Pines True Smile – Dentist in Pembroke Pines

Give Us a Call!

(954) 703-2474

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Office Hours

Mon - Fri   9AM - 5PM

Filling out this form at home will save you a lot of time. Please print and complete the appropriate form below before you come in for your appointment.

Friendly Reminders

  • Please arrive 15 minutes early to fill out your patient forms.
  • If you have a medical condition which requires premedication, please request a prescription prior to your appointment, or if you are unsure, please contact your office.
  • Your teeth cleaning may be performed at your first visit.
  • If necessary, our patient coordinator will discuss and assist you with insurance and maximizing your benefits or financing options.

Patient Forms:

General New Patient Form

Plantillas de Pacientes:

Planillas generales para nuevos pacientes