New Patient Dental Online Forms

Welcome to Brush n Brace! In order to make it easy for your first visit with us, you can fill out our new patient dental form electronically.
If you have any questions you can always call our office at: (858) 800-2000 and we’ll be more than happy to help you out. If you’re not able to fill it out before the appointment, then please arrive 10-15 minutes before your child’s appointment. Thank you!


First, let’s get the boring stuff out of the way. For your first visit, we will need information about you.

We have 2 forms, one to be filled out by one of your parent’s/guardian and one to be filled out by you! It’s not too complicated, you can either fill it out on our secure server or download the form and email it back to us! We’ve tried to make it as easy, breezy for you! If you need any help, just give us a ring, we’re here for you!

SSL site seal - click to verifyAll information is transmitted over a secure connection and will never be distributed or sold to any third parties. We are compliant and observe all HIPAA Regulations.

Form to be filled out by Parent/Guardian

Fill out our new patient dental forms online, before your appointment at Brush n Brace in San Diego CA. A specialty office for teens.

Do you have some pictures or x-rays you would like to send us before your visit? Click here to upload them to our secure server.

Alternate way to fill out new patient paperwork (you do not need to do both)

You can download form to your computer and email it to us at:

We do ask that you fill it out and email the form to us as soon as possible so that we can have everything ready for your appointment.

Please save the file to your computer and open the file with Adobe Reader. If you do not have Adobe reader installed on your computer, you can download it for free at:

Once the file is open in Adobe Reader, please type in your answers and save file. You don’ need to worry about signing the form, we can do that here at the office.

Download new patient dental form