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 Form

For the convenience of our Lebanon, Ohio patients, we provide a prompt and safe Brace Bus to help transport your child to his or her appointment!  Please print and complete all three forms below to participate in the Girdwood Orthodontics Brace Bus.  Completed forms may be scanned and emailed to info@girdwoodortho.com or dropped off at our Lebanon Office location.