At the office of Dr. L’Tanya Joy Bailey, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax us your printed and completed forms or you may bring them during your visit.
New Patient Registration Form – English – Complete Online
New Patient Registration Form – Spanish – Complete Online
Informed Consent for the Orthodontic Patient – Spanish – Download & Print
Informed Consent for the Orthodontic Patient – English – Download & Print
Adult Medical History – English – Download & Print
Adult Medical History – Spanish – Download & Print
Under 18 Medical History – English – Download & Print
Under 18 Medical History – Spanish – Download & Print
Request for Release of Patient Records – Download & Print
Notice of Privacy Practices – Download & Print
Patient Attendance Policy – English – Download & Print
Patient Attendance Policy – Spanish – Download & Print