Child Online Forms

To make your visit to our orthodontic office more smooth and efficient, we ask that you complete the following forms below before your scheduled appointment.  Please select the appropriate office below to submit your forms to the correct office.

  • Asheville Office

    The following forms will be submitted to the Asheville office.

      child New patient Forms

    Please fill-out the appropriate forms below.

    CHILD PATIENT INFORMATION & MEDICAL HISTORY

    Great Smiles Medical History Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Please complete, sign and submit both pages.

    Fill online

     

    RELEASE OF INFORMATION

    Great Smiles Release of Information Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     

    INSURANCE CARD

    Great Smiles Insurance Card for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     All About Me

    We want to know what makes you......YOU!  Tell us more about yourself by completing the following form. 

    All About Me

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

     

    Fill online

  • Sylva Office

    The following forms will be submitted to the Sylva office.

      child New patient Forms

    Please fill-out the appropriate forms below.

    CHILD PATIENT INFORMATION & MEDICAL HISTORY

    Great Smiles Medical History Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Please complete, sign and submit both pages.

    Fill online

     

    RELEASE OF INFORMATION

    Great Smiles Release of Information Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     

    INSURANCE CARD

    Great Smiles Insurance Card for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     All About Me

    We want to know what makes you......YOU!  Tell us more about yourself by completing the following form. 

    All About Me

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

     

    Fill online

  • Waynesville Office

    The following forms will be submitted to the Waynesville office.

      child New patient Forms

    Please fill-out the appropriate forms below.

    CHILD PATIENT INFORMATION & MEDICAL HISTORY

    Great Smiles Medical History Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Please complete, sign and submit both pages.

    Fill online

     

    RELEASE OF INFORMATION

    Great Smiles Release of Information Form for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     

    INSURANCE CARD

    Great Smiles Insurance Card for Children

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

    Fill online

     

     All About Me

    We want to know what makes you......YOU!  Tell us more about yourself by completing the following form. 

    All About Me

     

    Filling out the form online is easy. Simply click the "Fill online" button below, following the instructions and click "Done" to submit your form.

     

    Fill online

Contact Us

Asheville Office: 828-274-8822
Sylva Office: 828-586-9333
Waynesville Office: 828-407-4034
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

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