Robert Silverstein, DMD, MS, PA

Orthodontics for Children and Adults

New Patient Forms

  • Complete Online: Patient information form (for all ages) - use this link if you want to complete an online form and submit it to us electronically. This is our preferred method. When you click the Submit button at the bottom of the form, your information will be emailed directly to Dr. Silverstein, but currently in unencrypted format. If you would prefer not to send your information this way, you can print the appropriate form below, fill it out, and bring it with you to your initial vist.
  • Patient Information Form for patients under 18 years of age - The form will open in a new tab or window so you can download it and/or print it out.
  • Patient Information Form for patients over 18 years of age - use this link if you want to print out the form and bring it in with you.
  • HIPAA Acknowledgment that you received our HIPAA policy
  • Insurance Claim Form

Existing Patient Forms