Patient Forms

At Dr. Kevin McCoy Orthodontics, we know your time is valuable! To help cut down on time spent in the office, we offer our New Patient Health History and various Informed Consent forms online. Please complete and submit any applicable forms using the links below.

Health History Form »

HIPAA Acknowledgement »

Informed Consent for Orthodontic Treatment »

Informed Consent for Invisalign Patients »

Informed Consent for Patients with Periodontal Concerns »

Informed Consent for Patients with an Impacted Tooth or Teeth »

Written Authorization for Funds Withdrawal »

Supplemental Consent and Health Questionnaire

As of May 13, 2020, all patients should complete our new Supplemental Consent form. This form only needs to be completed once. Prior to every appointment, please complete our Supplemental Health Questionnaire. Please contact our office if you have any questions.

Supplemental Consent »

Supplemental Health Questionnaire »