First Visit

First Visit

Patient Forms

This form can be downloaded to your computer and either filled in by typing into it or printing it and then filling it in. Please bring it to your appointment. Please note that emailing the completed form would be a violation of HIPAA and therefore should not be emailed back to our office.

» Patient Information and
Health History Form [DOC]

» New Patient and
Office Information [PDF]

» New Patient Questionnaire [PDF]


  • Call our office.
  • Our reception staff will be happy to schedule your initial visit.
  • We will send you the Patient Information Form and the Patient Health History Form or you may download them from this site.
  • Bring these completed forms with you to your scheduled appointment.


Our New Patient Coordinator will take great care of you at your initial visit. She will:

  • Go over your main concerns
  • Take some photos of your teeth
  • Take an x-ray of your teeth

Dr. Goldreich will:

  • Go over your pictures and x-rays on the computer
  • Do a thorough exam
  • Discuss the problems that need correction
  • Explain his treatment plan and length of treatment
  • Answer any questions you may have

New Patient Coordinator will:

  • Go over any further questions/treatment
  • Show you exactly what appliances Dr. Goldreich has prescribed
  • Go over the investment and payment options


  • Impressions will be taken of your teeth
  • An x-ray will be taken to evaluate your skeletal structures


  • The appliances that Dr. Goldreich prescribed will be placed
  • Thorough instructions on how to care for your appliances will be explained


  • Depending on the appliances that you are wearing, you will be seen at different intervals ranging from every four to ten weeks.

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