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Pediatric Dental at Bridgeport
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    • Meet Dr. Ben Kang
    • Meet Our Team
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    • Testimonials
  • About Your Child
    • First Visit
    • Before Appointments
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  • Contact Us
    • Directions
    • Request Appointment
    • Referring MD/DMD
  • About Us
    • Meet Dr. Ben Kang
    • Meet Our Team
    • Office Tour
    • Testimonials
  • About Your Child
    • First Visit
    • Before Appointments
    • Patient Forms
    • FAQs
  • Contact Us
    • Directions
    • Request Appointment
    • Referring MD/DMD

Patient Forms

For new patients, please read and print the following forms:
  • First Visit Information
  • Patient Registration
  • Medical & Dental History for ages 0-3
  • Medical & Dental History for ages 4-11
  • Medical & Dental History for ages 12+
  • Notice of Privacy Practices
  • Appointment & Financial Policy
For release of records requests:
  • Record of Release Coming To Our Office
  • Record of Release Going From Our Office

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