Patient Forms


Adult Health History*

This form is necessary for the first visit to our office. It will aid us in investigating insurance benefits, submitting claims on your behalf, and creating a no-interest payment option.

* This is a large PDF. Please be patient while it downloads.
Insurance Form

This form is necessary for each patient’s first visit to our office. It will aid our financial coordinators in investigating any insurance benefits, submitting claims on your behalf, and creating a no interest payment option.

Child Health History*

This form is necessary for your child’s first visit to our office and should be printed and completed prior to your arrival.

* This is a large PDF. Please be patient while it downloads.
Flex & Insurance Info

This form has helpful information on how orthodontic insurance benefits work as well as flexible spending accounts.


Suresmile Scanning Appointment

This document describes the details of your scanning appointment for you, what to expect, why we need to scan, and FAQs about the procedure.

Scopace Information

This document contains the patient information regarding the use of Scopace for your scanning appointment.

Suresmile Custom Wire Appointment

This document describes the details of your custom archwire appointment. Get all of the FAQs about this essential piece of our high-tech orthodontic process.

Sal-Tropine Patient Information

This document contains our patient information regarding the use of Sal-Tropine for your scanning appointment.




Birmingham
2388 Cole Street, Suite 103
Birmingham, MI 48009
248-258-8283

birmingham@tdrortho.com

Novi
39500 West 10 Mile, Suite 102
Novi, MI 48375
248-888-8552

novi@tdrortho.com