Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

New Patient Health History Form

If you're unable to open PDF files, you can get Adobe Reader® for free.

Financial information

Making treatment fit your budget

We will review your custom plan, payment options, and insurance before treatment begins so you know what to expect.

View financial information

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Map of Van Allen Orthodontics at 10921 Wilshire Blvd, Los Angeles