Patient Forms

Patient Forms

For your convenience, a list of our patient forms with links to fill in your information are provided below. If you have questions about any of our patient forms or services, please contact us here or call our office at 616.942.9840.
Click On The “Get Started” buttons Below To View and Complete our Patient Forms:

Please Only Fill Out Forms If Your Child Has A Scheduled Appointment and Only Fill Out Forms That Pertain to your Appointment.

New Patient Packet

Healthy Kids Frenectomy New Patient Packet

Frenectomy New Patient Packet

Hygiene Appointment (returning patient)

Other Appointment

Conscious Sedation Appointment

COVID-19 Questionnaire

To learn more about our Grand Rapids dentist at Mitten Kids DentistryBrett Kingma DDS and Grady Randall DDS or to request an appointment, please contact our office or call us directly at 616.942.9840.

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