Our forms & referral slips are available for you to download & print at your convenience. 

New Patient Forms

Please download and print the applicable new patient form (child or adult) and HIPAA consent below. To save time on the day of your consultation, please complete the New Patient Form prior to your first visit with us. You may also fill the forms out on the day of your consult.

You can submit the forms by fax at 925-718-3116, email: info@tri-ortho.com, or bring the completed form with you on your first visit.

Doctor Referral Forms

Tri-Valley Orthodontics Brochure – Updated

To open or read our downloadable forms you will need Adobe®Reader®. If you don’t already have Adobe® Reader® installed you may click here to download it for free.

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