Department of Dentistry | Forms and Paperwork

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Patient information and health history form

At your first appointment to our clinic, you will be asked to complete a Patient Information and Health History Form. Completing this form prior to your appointment will help speed up your check-in process.

Medical record release form

Before we can release your child's health information, you must submit written permission. Complete the form below to submit your request.

General information

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944