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Forms

New Patient & General Anesthesia Forms - Dr. K's Pediatric Dentistry

Simply click on the link below from the convenience of your own home or work to complete the necessary paperwork for an upcoming new patient appointment. When submitted, your information will automatically and securely transmit to our office. If you prefer, you may also print the documents to fax or email to our office, or bring with you to your appointment.

If your child will be, or has been, scheduled for treatment that requires the use of General Anesthesia, please click on the link below and complete the necessary forms. When submitted, your information will automatically and securely transmit to our office. If you prefer, you may also print the documents to fax or email to our office, or bring with you to your appointment.

Referral Forms

Dr. K's Pediatric Dentistry welcomes and values other health care providers consultation requests and referrals.  Upon examination of the patient, referral sources will receive a report of findings, recommendations, and/or any treatment performed. You may refer patients to our office by filling out the referral form below and sending it along with the patient, faxing it to our office at (907) 745-5457, or emailing it to us at info@matsumoose.com.  Thank you!

Dr. K's Pediatric Dentistry, kid dentist, Palmer, wasilla, eagle river, Alaska