Patient Forms

We have streamlined our forms to include procuring your insurance information and permission to treat your child. Accurate medical information is very important to provide excellent care of your child. Also, we are happy to submit your insurance claim, but need your help in completely filling in the required information.

Dr Evangelisti and her staff would like to learn about your child’s habits and diet in order to help your child have optimum dental health. The information you share with us helps us know what tools, tips, and advice we might share with you to give your child the best start to keeping his/her teeth healthy for a lifetime! Habits start early and are very hard to break later. So let us help you give your child good habits!


Click below to download New Patient Registration Materials. Once you have filled them out please send to or bring them with you to your first appointment. Thank you!