George Wedell, DSS, DS

Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • If your child is the one undergoing treatment, fill out this form: Patient Form (Child) PDF | DOC
  • If you are over the age of 18 and paying for your own treatment, fill our this form: Patient Form (Adult) PDF | DOC
  • If your child is undergoing treatment and you are considering it for yourself, or have multiple children needing treatment, fill out this form: Patient Form (Child & Adult) PDF | DOC

If you’re unable to open PDF files, you can get Adobe Reader® for free.

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