Dentistry for Children
Pediatric Dentistry
2551 North Green Valley Parkway, Suite 400A, Henderson, NV 89014
702-458-6684
  • Patient Information
    • Introduction
    • First Visit
    • Scheduling
    • Financial Policy
    • Insurance
    • Privacy Policy
    • Sedation
    • Pain Control
    • FAQ
    • Laser
    • New Techniques
  • Pediatric Dentistry
    • Introduction
    • Tooth Brushing
    • Thumb Sucking
    • Tooth Eruption
    • Baby Bottle Decay
    • Cavity Prevention
    • Gum Disease
    • Adolescence & Oral Care
    • Trauma & Other Post Op Care
  • Othodontics
    • Introduction
    • Removable Appliances
    • Types of Bites
    • Classification of the Teeth
  • Meet Us
    • Meet Dr. Sina
    • Meet the Staff
  • Games
    • Color Picker
    • Coloring Charts
    • Connect to PBHS Games
  • Online Forms
    • Patient Registration
    • Referral Form
    • Office Forms
  • Contact Us
    • Henderson Office Map/Directions
    • Las Vegas Office Map/directions

Online Forms

  • Patient Registration
  • Referral Form
  • Office Forms

Office Forms

Please click on the thumbnails below to download and fill-out our office forms. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

ABC Parent Information Form

ABC's Parent Information

care of retainers

Care of Space Maintainers

Laser Dentistry

Laser Dentistry Form

post op form

Postoperative Instructions

post op extractinos form

Postoperative Instructions for Extractions

sealants form

Sealants

xylitol form

What is Xylitol?


Technical Note:

PC Users
Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.

 

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Dentistry for Children

Address: 2551 North Green Valley Parkway, Suite: 400A, Henderson, NV 89014 .::. Phone: 702-458-6684 • Fax: 702-450-9498

Address: 700 E. Silverado Ranch, Suite: 110, Las Vegas, NV 89014 .::. Phone: 702-431-6600 • Fax: 702-450-9498

 

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