Skip to main content
Steinmetz Pediatric Dentistry

 New Patient Forms

We are so excited that you have selected us to be your child's dental home.

We are looking forward to meeting you. We are a super friendly group so get ready for some high fives, hugs and all around fun for your little ones!

Check out our facebook and instagram to see all of our fun first visit pictures!

To fill out the new patient registration form online, copy and paste the link below into your internet browser:

We cannot wait to meet you!

If you are having troubles with the online registration please follow the 4 links below and print out each form. After you fill out the paperwork you can email a picture of it to or you can fax it to (205)823-1590

    Patient Registration Form.pdf  Insurance Form.pdf   Photo_Release_Form.pdf and Medical_history_printout.pdf