Amherst Orthodontics

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Forms

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To get started, print and fill in the "Transportation Authorization for the Spike Mobile" form and bring it to your child's next appointment.

Transportation Authorization for the Spike Mobile - This form must be completed and in our files before your child can ride our SPIKE MOBILE.

School Release Permission Form for the Spike Mobile - Preprinted notes authorizing the school to release your child on the day of his orthodontic appointment. Feel free to make additional copies, as needed. Please use the Spike Mobile pick up time for the time of release, NOT your child's appointment time.

Spike Mobile Guidelines - Outlines guidelines for parents and riders to make a safe and smooth riding experience. This also explains program details.

Spike Summary – A sample clinical report to keep you informed of your child's progress each time they ride the SPIKE MOBILE.

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Dr. Deb DeBeradinis and Dr. Diane Shieh specialize in orthodontics for children, teens and adults,
and serve many towns in Southern NH from Milford and Nashua, all the way to Peterborough!

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