New Patient Forms

Feel free to download the forms you need right from our website! These forms are in PDF format and require a PDF reader such as Adobe Acrobat (Windows) or Apple Preview (Macintosh).

Patient History Form

T-19 Health Check Form - Milwaukee

T-19 Health Check Form - Beloit

Patient Referral Form

Dental Clearance Form

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The Orthodontic Care Center
1421 South 108th St. Milwaukee WI 53214
1-414-771-5100 1-414-908-9384 USD Cash, Check, MasterCard, Visa, American Express, Most Dental Insurance Plans, CareCredit, Lending Club Patient Solutions, Prosper Healthcare Lending
Anas Najjar Doctor