New Pt Pack - TLC Pediatric Dentistry, LLC Laura B Miner, DDS 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your child's name, sex, nickname, birthdate, and age. This information is crucial for identifying your child in the system.
3. Provide contact details including home address and phone numbers. Ensure accuracy for effective communication.
4. Complete the health information section thoroughly. Indicate any chronic conditions or medications your child is taking to assist the dental team in providing safe care.
5. In the dental history section, detail previous visits and any dental issues your child has faced. This helps establish a comprehensive treatment plan.
6. Review the consent for services and payment policy sections carefully. Sign where indicated to confirm your understanding and agreement.

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