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954-741-0707

Opening Hours

Mon-Sat: 9:00 A.M - 5:00 PM Sun: Closed

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Your perfect smile is a click away!

Patient Forms

Changing Lives One Smile At A Time

Our new patient and medical history update forms can be downloaded and printed out using the following links.

Please bring your completed New Patient Forms with you on your first visit.

These forms are in the Adobe Acrobat format (PDF). If you do not currently have the Adobe Acrobat Reader, you may download it by clicking on the icon below.

New Patient Forms

New Patient Forms for Adults (Ages: 14 and Up)
NEW PATIENT FORMS – ADULTS.pdf
Adobe Acrobat document [1.7 MB]
New Patient Forms for Children (Ages: 2-13)
NEW PATIENT FORMS – CHILD.pdf
Adobe Acrobat document [1.5 MB]

Medical History Form to Update for Adults and Children

Medical History Form.pdf
Adobe Acrobat document [405.8 KB]

Make your dream smile a reality!

Our office is proud to provide you with expert treatment and consultations. We invite you to meet Dr. Kusnick and all our caring team, and visit Services Offered for details on the comprehensive services we provide.