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On your first visit, to save time at the
office filling out forms, you may print out the forms we require
and complete them at your leisure. Bring them with you on your
first visit, or fax them to the office ahead of time. Click on the below
links to view and print each one.
Financial
Policies Form
Privacy Notice Form
Health History Form-English
Health History
Form-Spanish
To print the forms you will need Adobe Acrobat Reader. If
you do not have Adobe Acrobat, please
click
here to download it for free to
your computer.
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Arizona Dentists ~ Dr. Mike Kort
(Pediatric Dentist), Dr. Charles Lucero & Dr. Nate Urquhart (General Dentists)
Kids Little Smiles Dentistry for Children.
Serving children in the surrounding cities and suburbs
of Bullhead City, Golden Valley, and Lake Havasu,
Arizona areas.
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