New Patient Form

Prior to your first visit, please take a few moments to complete our secure online new patient health history form. Completing this form prior to your arrival will enable us to get right to your appointment, saving you valuable time and helping us provide you with the best possible experience.

Click here to access the form.

Additionally please click here to download and print the Insurance Benefit Questionnaire (Please fill this form out prior to your first appointment.)

Notice of Privacy Practice

Also, if you have orthodontic insurance coverage, please bring the necessary paperwork so that we may assist you in confirming your benefits and filing your claim. To determine what your benefits are, please contact your insurance company and ask the following questions:

• Do I have orthodontic coverage?
• What are my benefits?
• Is a pre-treatment estimate required?
• Does the insurance company pay automatically?

Contact Mandy at: mandyc [at] paquetteortho [dot] com (subject: Inquiry) (Email)