New Patient Forms

New   Patient Forms

The Smile Spot Online New Patient Forms

 

Click to complete the new patient online forms for the office of your choice. Complete our new patient forms below before you come in for your visit to reduce time spent in the office! Please complete all pages of each form. 

The Smile Spot Springfield

Click the link to go to the corresponding New Patient Forms

Orthodontic Forms

Child (under 18) English 

Child (under 18) Spanish 

 

Adult (over 18) English

Adult (over 18) Spanish

Pediatric Forms

English Pediatric New Patient Forms

 

Spanish Pediatric New Patient Forms

Springfield Pediatric Dental Forms

  1. English:                                                 2. Spanish: 

 

Springfield Orthodontic Forms

 

Adult Forms (18+ older)

  1. English:                                                 2. Spanish: 

 

Child Forms (Under 18)

  1. English:                                                 2. Spanish: 

The Smile Spot Springfield

New Patient Forms

1324 E. Montclair Street Springfield, MO

If you are a patient of The Smile Spot Springfield, please choose either Pediatric or Orthodontic Forms. If you are an orthodontic patient please make sure to fill out either the adult or child forms based on the age of the patient.

For questions call 417-886-9939

or email s1info@thesmilespot.com. 

The Smile Spot Independence

Click the link to go to the corresponding New Patient Forms

Orthodontic Forms

Child (under 18) English

Child (under 18) Spanish

 

Adult (over 18) English

Adult (over 18) Spanish 

Pediatric Forms

English Pediatric New Patient Forms


Spanish Pediatric New Patient Forms

Independence Pediatric Forms

  1. English:                                                 2. Spanish: 

 

Independence Orthodontic Forms

 

Adult Forms (18+ older)

  1. English:                                                 2. Spanish: 

 

Child Forms (Under 18)

  1. English:                                                 2. Spanish: 

The Smile Spot Independence

New Patient Forms

651 E US Hwy 24, Independence, MO 64050

If you are a patient of The Smile Spot Independence, please choose either Pediatric or Orthodontic Forms. If you are an orthodontic patient please make sure to fill out either the adult or child forms based on the age of the patient.

For questions call 816-461-0300

or email independencebraces@thesmilespot.com. 

The Smile Spot Waldo

Click the link to go to the corresponding New Patient Forms

Orthodontic Forms

Child (under 18) English

Child (under 18) Spanish

Adult (over 18) English

Adult (over 18) Spanish

Pediatric Forms

English Pediatric New Patient Forms: 

Spanish Pediatric New Patient Forms

Waldo Pediatric Forms

  1. English:                                                 2. Spanish: 

 

Waldo Orthodontic Forms

 

Adult Forms (18+ older)

  1. English:                                                 2. Spanish: 

 

Child Forms (Under 18)

  1. English:                                                 2. Spanish: 

The Smile Spot Waldo

New Patient Forms

8043 Wornall Rd, Kansas City, MO 64114

If you are a patient of The Smile Spot Waldo, please choose either Pediatric or Orthodontic Forms. If you are an orthodontic patient please make sure to fill out either the adult or child forms based on the age of the patient. For questions call 816-363-2900 or email waldobraces@thesmilespot.com. 

The Smile Spot Midtown

Click the link to go to the corresponding New Patient Forms

Orthodontic Forms

Child (under 18) English 

Child (under 18) Spanish

 

Adult (over 18) English

Adult (over 18) Spanish

 

Midtown Orthodontic Forms

 

Adult Forms (18+ older)

  1. English:                                                 2. Spanish: 

 

Child Forms (Under 18)

  1. English:                                                 2. Spanish: 

The Smile Spot Midtown

New Patient Forms

3315 Gillham Plaza Rd, Kansas City, MO 64109

If you are a patient of The Smile Spot Midtown, please complete the Orthodontic Forms. Please make sure to fill out either the adult or child forms based on the age of the patient.

For questions call 816-756-2273

or email midtownbraces@thesmilespot.com. 

If you have questions or need additional assistance please contact your local Smile Spot office.

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