Patient Forms

Before your first appointment with us, we encourage you to complete the forms linked below. This will save time in the office and help us get started on your care as quickly as possible.

If you are using the online forms, please complete and submit the forms via this website. If you are printing the forms, please print and complete the forms, and bring them to your appointment.

Online Forms

Pediatric Dentistry New Patient Forms

Orthodontic New Patient Forms

Referring Doctors

adobe download*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

**We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

***For Apple/Mac Users: You must use Adobe Acrobat Reader to submit the forms. To do so, simply right click on the form and save form. Open form in Acrobat Reader, fill out the form and submit.

Televox Root Site

  • Televox Main Office - 1110 Montlimar Dr. Suite 700, Mobile, AL 36609 Phone: 1-800-644-4266

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