patient forms

From our family to yours

“My experience with Diane & her team was wonderful! Everyone was friendly, professional, and kind. All my needs were met and I am so happy I did it!” ~ Elizabeth C.

“Amherst Orthodontics is the only place I’ll recommend to my friends. The friendly & caring staff make every visit pleasurable.” ~ Amy C.

“My family has had a wonderful first time experience at Amherst Orthodontics. Everyone there was always friendly and super helpful.” ~ Jennifer R.

“A positive experience start to finish! Always pleasant, always on time and it has been fun getting to know the staff.” ~ Patricia H.

“Everyone is so nice here and my teeth look amazing. I really like that they got to know me as a person instead of just another patient.” ~ Cynthia M.

Patient Forms

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Please take a minute to print and fill out the patient information form before your first appointment:

  • Child Medical History [PDF]
  • Adult Medical History [PDF]
  • Financial Form [PDF]

If you’re unable to open PDF files, you can get Adobe Reader® for free.

New Patient

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