Patient Information Form

Secure Digital Patient Information Form

Welcome to Kidz Dental Care, the premier center in Myobrace® pre-orthodontics and pediatric dental care.
  • Please fill out the secure patient information for below for our records before your first visit.
  • We prefer a digital record; however, if you feel more comfortable filling out a paper copy, you may download and print a PDF copy of the form to bring in to the office.

Patient Forms


Our Office

Santa Clarita

18580 Via Princessa, Suite 3,
Santa Clarita, California 91387
(661) 388-0499
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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.