Jennifer Stachel Orthodontics Forms

Patient Forms

New patients are welcome to complete their registration prior to your visit using our secure online Registration Form. Once the form has been completed, please be sure to press the Submit button to automatically send us your information. Please be assured that every precaution has been taken to ensure that our patients’ private health information remains secure.

For your convenience, click on the links below to complete our patient forms.

Online Patient Medical Forms


Medical History

Paper Forms


Health History
Signature On File

COVID Intake Form


COVID Intake Form