Waterfront ORthodontics
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Patient Registration
and Medical History Form
We will mail you the following form prior to your first visit to our office. However, if you wish, you may print the form from this site and bring it with you to your initial visit.

All forms are in pdf format. To read and print them, you'll need Acrobat Reader, which is available for free download from Adobe.

Adobe PDF File

Click HERE to Download Patient Registration and Medical History Form
 
Patient Form
   

110 North Mountain Blvd.
Mountaintop, PA 18707
(570) 474-9565

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Waterfront Complex
672 North River Street
Suite 213
Plains, PA 18705
(570) 825-7583
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