For your convenience, you may download, print and fill out the following forms and bring them to your next appointment:
- New Patient Form (Adult)
- New Patient Form (Child)
- HIPAA Patient Acknowledgment and Consent
- Informed Consent
https://www.westcobborthodontics.com/new-patients/patient-forms/ . They are also saved in the shared drive.
Transfers Records Forms
If you are transferring from another orthodontic practice, you may also download, print and fax this form to West Cobb Orthodontics at (678) 401-6263 and we will request your records. There is a generic form if you are transferring from another orthodontic practice and a specific form if you are transferring from my previous practice.
These forms require Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, click the Adobe logo to download.
We welcome you to contact our office today at 678-401-4321 to learn more and to schedule an appointment with our orthodontist in Kennesaw, Georgia, Dr. William K. Farrar, Jr..