Returning Patient Forms

Please Click the button to download our returning patient intake form and email it back to us or bring it with you on your next visit.
Click to Download Returning Patient Form

***Alert: For the safety of your child and due to new regulations, if you have not filled out the Complete Medical History for your child before, please download and fill out the following form for each of your children***Click to Download Complete Medical History Form

We look forward to seeing you again. 

And as always…Welcome Aboard the Happy Tooth Train!


Here are some suggestions to aid you:

1. Make the appointment day as easy as possible and try to see that your child is well rested.

2. It is best to tell a young child about a dental visit the day of the appointment.

3. If your child requires more information, you can say,
“The dentist will look at your teeth to make sure they are healthy.”

4. Try to convey the feeling that dental visits are a normal part of growing up.

(Sometimes the promise of a reward for “going to the dentist” inadvertently implies that there is something to fear.)

5. Of course, always avoid the threat of a dental visit as punishment for misbehavior.

At Urbach Pediatric Dentistry we are committed to a policy of prevention. By seeing children early in life we can often reduce the incidence of dental decay and infections with early preventative treatment techniques. Recognition and early treatment planning of developing orthodontic problems often enable us to either correct the problem or lessen the severity of the problem, thereby resulting in much better long-term results. Your child, with our help and your participation, can become an excellent dental patient with a healthy mouth and a confident smile.

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