New Patient

Information

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Patient information & medical history

Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. We understand that your child may hesitate a little about visiting the dentist and that is why we strive to combine a quiet but fun atmosphere and the best staff to help make this happen. When building our new pediatric dentist office in Herriman, it was our goal to create a calm but fun environment that kids would be excited about. With our awesome play area and our themed treatment rooms, we’ve done everything possible to help make your child’s visit to the dentist relaxing yet fun. With our 3-story treehouse and a selection of fun decorations and furniture that would make Ikea jealous, we hope we have done just that!

  • Child's Name

  • FATHER

  • MOTHER

  • PRIMARY DENTAL INSURANCE

  • SECONDARY DETAIL INSURANCE:

  • HEALTH (medical) INSURANCE INFO:

  • REFERRAL INFORMATION

  • DENTAL HISTORY

  • MEDICAL HISTORY

  • DOES YOUR CHILD HAVE, OR PREVIOUSLY HAD, ANY OF THE FOLLOWING

Our Pediatric Dentistry  Services

Our team’s training and experience allow us to provide a safe and comfortable experience for your child, whether your child is ready for their
6-month dental checkup or a more extensive oral procedure. Below is a listing of the most common procedures we perform in our children’s dentistry office.
If you have any questions about any of these procedures or think your child might be in need of an appointment, contact us today! We are excited to help your child on their way to healthy oral hygiene.

Contact Us Online, or Call and Make an Appointment Today!

We are excited to have you and your child come in and visit our office! Schedule an appointment today by giving us a call. You can also connect with us through our Facebook page.

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