Patient Forms

MANY WAYS TO FILL OUT YOUR FORMS!

Online

This link will direct you to a secure server where you may complete your new patient information online. All of our online forms are submitted via a secure connection and are HIPAA compliant.

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Download & Print

You can download new patient paperwork in advance or arrive 10 minutes early and we’ll be happy to help.

New Patient Information  |  Medical History  |  Insurance

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PATIENT INFO

Access your account balance, make online payments, and view your scheduled appointments in one place.

Patient Login

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205.733.2022

 

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LIFETIME SMILE GUARANTEE

If for any reason you’re not happy with your smile, then we’ll fix it at a substantial discount!

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Some Things Our Patients Say

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  • LOVE Birmingham Orthodontics
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