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Patient Forms

Teenage girl smiling with braces

For your convenience, you may download, print and fill out the following forms and bring them to your next appointment.

Graduate Clinic Forms:

  • New Patient Registration Form and Medical and Dental Questionnaire
  • Release of Orthodontic Records Form

Faculty Practice Forms:

  • New Patient Registration Form
  • Medical and Dental Questionnaire
  • Release of Orthodontic Records Form

**Please use umortho@umn.edu to send or receive records** ​


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*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

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Division of Orthodontics • Dental Clinics

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Moos Tower
515 Delaware St. SE
Minneapolis, MN 55455
612-625-6444

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