New Patient Forms

COVID-19 Forms

Please fill out the following forms ahead of your next appointment.

New Patient Forms

You may access the following forms to assist us with your care. Please fill out the desired form, then submit.

Brace Bus Forms

For the convenience of our Lebanon City Schools patients and our Monroe City Schools patients, we provide a prompt and safe Brace Bus Service to help transport your child to his or her appointment!  Please print and complete all three forms below (corresponding to your school system) to participate in the Girdwood Orthodontics Brace Bus Service.  Completed forms may be scanned and emailed to tinah@girdwoodortho.com or dropped off at our Lebanon or Monroe Office locations.

Lebanon Brace Bus Forms