New Patient

New Patient Forms

To make it easier for you, we’ve provided our patient forms to you. If you’re not able to complete those forms in advance of your visit time, you must arrive at least 30 minutes before the time of your appointment to fill out the forms.

FAQ – How Can We Help For You?

Our new patient forms request your personal contact information, dental and medical health history, current medications, insurance information, and emergency contact details. Completing these forms before your first visit allows our clinical team to review your history and prepare a more personalized and efficient first appointment.

Yes! We offer online new patient forms for your convenience. Completing your paperwork digitally before your visit saves time in the office and allows our team to prepare for your specific needs. Simply visit our New Patient Forms page and complete your forms from any device at your convenience.

Please bring a valid photo ID, your dental insurance card (if applicable), any completed new patient forms (if not submitted online), a list of current medications, and any recent dental X-rays from your previous dentist. If you have existing dental records you would like us to review, you can arrange to have them transferred before your visit.

If you have completed our online new patient forms in advance, arriving 5–10 minutes early is sufficient. If you prefer to complete forms at the office, we recommend arriving 15–20 minutes before your scheduled appointment time. Either way, our front desk team will ensure a smooth and welcoming check-in process.

Absolutely. All information you provide is protected under HIPAA (Health Insurance Portability and Accountability Act) regulations. Your health information is stored securely and accessed only by authorized team members involved in your care. Our full HIPAA Notice is available on our Patient Information page for your review.

Testimonials

Jessica

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"My first time at Extraordinary Smiles was a fantastic one! I am very nervous at the dentist and when told I would need a procedure done I was visibly upset. Carmen and Dr. K made me feel at ease about the appointment and scheduled it so that they would both be there with me. I would recommend Extraordinary Smiles to everybody especially if you are nervous."
Regina

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"My family has been coming to Extraordinary Smiles for a few years now. We all have had great experiences. I think Dr Ladani is truly an exceptional dentist. He does excellent work with fillings, implants and crowns. The staff is very friendly and helpful too."
Matthew

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"It’s always a pleasant and professional experience at every Extraordinary Smiles appointment. The entire staff is friendly and helpful providing great dental work and outcomes."
Raydiris

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"Dr. Ladani is an exceptional dentist! The office is always spotless and welcoming. The staff is friendly and attentive, making every visit a pleasant experience. Plus, you rarely have to wait long to be seen. Highly recommended!"

Book Your Dental Visit Today

Need to see a trusted dentist? Easily schedule your appointment and choose a time that fits your busy schedule. We provide comprehensive dental care in a comfortable and modern environment.

Richlandtown, PA Trumbauersville, PA
Milford Square, PA Spinnerstown, PA
Perkasie, PA Coopersburg, PA
Sellersville, PA DeSales University, PA
Bethlehem, PA Emmaus, PA
Allentown, PA Lehigh County, PA
Orefield, PA North Whitehall, PA
Coplay, PA Slatington, PA
CALL US ON: (610) 799-0600
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