Are you new to UPD Dental Associates? We’re thrilled you’ve chosen us.  In order to save you time, please complete a Health History Form and bring it with you to your child’s first appointment.

The last page of our Health History Form is an acknowledgement that you’ve seen and reviewed our Notice of Privacy Practices To do so, please click the link provided. 

University Pediatric Dentistry Forms

• New Patient Health History Form
• Returning Patient Health History Form 
• Patient Bill of Rights
• Notice of Privacy Practices 

Division of Oral and Maxillofacial Surgery Forms

• ​New Patient Health History Form 
• Returning Patient Health History Form 
• Pre-Sedation Screening
• Patient Bill of Rights
• Notice of Privacy Practices 

Division of Orthodontics Forms

• Health History Form
• Handling Orthodontic Emergencies
• Patient Bill of Rights
• Notice of Privacy Practices 

Division of General Dentistry Forms

• New Patient Health History Form 
• Returning Patient Health History Form 
• Patient Bill of Rights
• Notice of Privacy Practices