Dodge City Location
705 First Avenue, Suite B
Dodge City, KS 67801
T 620.227.2234
T 1.800.491.3338

The forms in this section are provided for your convenience. We ask that each new patient fill out a "Health History Form" and a "Smile Questionnaire" when they arrive at the initial exam.

If you desire, please print a copy of the two forms, fill them out, and bring them with you to your initial exam. We also provide our forms in Spanish.

Our Forms in English
· Health History (Child)
· Health History (Adult)
· Smile Questionnaire

Our Forms in Spanish
· Health History (Child)
· Health History (Adult)
· Smile Questionnaire

© Copyright 2013 Bunkall Orthodontics