At Southern Maine Pediatric Dentistry, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax us your printed and completed forms or you may bring them during your visit.

  • New Patient Packet: PDF
  • Patient Update: PDF
  • No Cavity Club Consent Form: PDF
  • Sedation Instructions for Parents: PDF
  • Post-Op Sedation Instructions: PDF
  • Post-Op Tooth Extraction for Parents: PDF
  • How to Care for Space-Maintainer: PDF
  • Physical Exam Form for Hospital Visit: PDF
  • Operating Room Guidelines: PDF
  • Buddy Bear Program: PDF
  • Fluoride Test Kit Request: PDF
  • Brushing and Flossing Chart: PDF
  • Guardian Consent Form: PDF
  • Record Transfer: PDF

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