Johnsonlink Orthodontics would like to welcome you to our practice. Prior to your initial consultation with us, please fill out the registration and medical history form below. Doing so will minimize the amount of time filling out paperwork at your appointment so that they doctor and staff can focus more on your treatment. Please fill out the form completely and include all insurance information so that we can inform you of your coverage at your appointment. Your insurance will not be billed for your initial consultation, as these are complimentary.
The form can be saved and completed at a later time if you get interrupted while filling it out. Just click on "Save for Later" at the bottom of the form.
If filling out form for a minor, please fill in this section completely.
If the patient is an adult and responsible for themselves, then fill in this section with the patient's information
Insurance information needs to be completely and accurately filled out in order to inform you of your coverage
Please fill in the explanation boxes provided for all 'yes' answers
Appointment reminders via text messages are very convenient. Please include your provider to be included in this service.