Patient Forms - American Pediatric Dental Group

Patient Forms

New Patient Forms

Coral Springs

Lake Worth

Pembroke Pines

Plantation

Printable Forms

For your convenience, you may download, print and fill out the following forms and bring them to your next appointment:

Pre-Sedation Instructions at Sedation Center

Medical Clearance - Sedation Center

Medical Clearance For Dental Treatment Form

Release of Records

Treatment Decision Assignment

HIPAA Notice of Privacy Practices

List of Insurances Accepted

American Dental Plan Forms

American Dental Plan - New Patient Special

American Dental Plan - Recall Visits for patients of record

American Dental Plan - Limited Edition

American Dental Plan - American Aesthetic Dentistry New Patient Special

Meet Our Doctors

What People Are Saying

5/5
Miguel A.
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An incredibly wonderful dental clinic, its staff is highly qualified, a very professional and friendly staff, very attentive, the treatment of children being the best I have ever seen. I recommend this clinic and its doctors and technical staff 100%.
Ivonne A.
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My son has had his last three appointments here and we are super happy and satisfied, the dental assistant who treated us today (Her name is Akita I think) was exceptionally patient and a good explainer. The doctor was excellent too. Even though the location is a bit far from where I live, I 100% prefer to come to this location than to the nearest location. Thanks for everything and keep it up.
Kimberly M.
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Staff is always welcoming, but today they really went beyond. I am very grateful and pray God continue blessing them. I really recommend this place I have been taking my children here for almost over 8yrs. I had set appointments for my 2 children. But one needed an additional service and I had requested to be called for any cancellations due to insurance problems. They immediately without any hesitation started contacting the up coming set appointments that had not confirmed and were able to find a cancellation and my child was able to be seen for the additional service. Thank you so much for your help!
Mariangel V.
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I take my daughter for her annual visit every six month and every time I go is awesome! Doctors are very friendly and understanding with kids, and also take parents in consideration to join the process and explain everything you need to know about your child's dental health. Making and rescheduling appointments is very easy. And there's almost no wait time. Front desk staff is very polite and nice. Very happy with their services.
Staffica B.
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The office is clean and inviting. From the receptionist to the Dr, everyone was friendly. Ms. Eddy did a great job with my kids. She spoke in a caring manner and explained everything she was doing. The Doctor answered all of my questions and gave great feedback. I would highly recommend this office.
Now offering orthodontic treatment at our Lake Worth location! Schedule a free consultation today!