For your convenience, you may download and print your Patient Information Form. Our online forms use the Adobe Acrobat 5 Plugin to allow patients the convenience of completing their health history and registration forms from home or work.

Download Patient Information Form

Download Genral Information Form

Download Financial Information Form

Please download the free plugin from Adobe's web site if it is not already installed on your system. It is important that you have at least version 5 of the plugin, in order to successfully use our forms.


Life Smile Teen Dental Center
Springdale, AR - Rogers, AR