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New Patient Forms

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For your convenience, you may access the following forms to assist us with your care.

Online Forms

Please complete and submit the Patient History form online via this website.

Printable Forms

For the printable forms, please download, print and complete the forms. Then, bring them to your appointment.


*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

**We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

***For Apple/Mac Users: You must use Adobe Acrobat Reader to submit the forms. To do so, simply right click on the form and save form. Open form in Acrobat Reader, fill out the form and submit.

Statler Orthodontics

  • Statler Orthodontics - 7400 W. Camino Real, #110, Boca Raton, FL 33433 Phone: 561-368-3688

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