Patient Forms
Download and Print Forms
You can download the patient forms below to assist us with your care. Print the forms, fill them out, and bring them to your appointment.
Health History – English
Historia Clínica – Español
Patient Rights & Responsibilities – English
Derechos y Responsabilidades del Paciente – Español
Notice of Privacy Rights – English
About AC Pediatric Dentistry
We understand that going to the dentist can be overwhelming and scary. That’s why we strive to make the experience pleasant, easy, and fun for your child. We aim to create lifelong, healthy dental habits through education and positive experiences in the dentist’s chair.
Convenient South Florida Locations
Getting to the dentist has never been easier. We’ve got many convenient locations in South Florida, and many more coming soon! Take a tour of our offices, so you’ll know what to expect when you get here!