If you are a new patient, please fill out the form below.
You may print this form and bring it with you to your first appointment, or you can scan and email it back to us.
Happy & Healthy Patients!
We see patients of all ages! I have had as young as 2 and as old as 98! People that want their teeth for a lifetime understand the value of maintaining a clean and healthy mouth.
I take time to teach and explain procedures, which in turn, helps my clients have less anxiety. No question is too small! Fielding questions is a favorite part of my job.
My patients appreciate the individual time and attention they receive at my practice. Not only building relationships, but also trust over time is a goal of Healthy Smiles Shine.
19541 E. Parker Square Drive
Parker, CO 80134