Smiling young woman using a computer before a dental visit

New Patient Forms

Complete your child’s new patient health forms before the appointment using a phone, tablet, or computer.

Papillion Pediatric Dentistry offers a secure online form portal to make the new patient process easier for families. The portal guides you through the information we need before your child’s visit.

Completing the forms ahead of time helps reduce paperwork at the office and gives our team the information needed to prepare for your child’s appointment.

Secure submission: Your information is transmitted securely and sent directly to our Dentrix dental practice software in compliance with HIPAA privacy and security requirements.

Start New Patient Forms

Use the button below only for new patient forms. The form will open in a secure online portal.

Complete New Patient Forms opens in a new tab

Need Help?

If you have trouble opening or completing the online forms, please call our office at 402.502.1256. A clickable phone link is available in the contact information below.