Patient Forms

Thank you for trusting Lake Country Orthodontics for you dental needs. We appreciate your time and want to make your first visit as efficient as we can.  Please download the forms below, complete them and bring them to your first appointment to save time.  Alternatively, you can also fill out these forms in person when you come to Lake Country Orthodontics.

If you have any questions or concerns, do not hesitate to ask for assistance at (262) 567-8420.

New Patient Forms   NOTICE OF PRIVACY PRACTICES 155 KB ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES 69 KB HEALTH AND DENTAL HISTORY 118 KB PERSONAL INFORMATION SHEET 96 KB

This web site uses files in Adobe Acrobat Portable Document Format which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

Lake Country Orthodontics - Dr. Matthew Noyce

1020 Oconomowoc Parkway Suite B Oconomowoc, Wisconsin 53066 Phone: (262) 567-8420 Fax: (262) 567-8428

697 Grand Ave. Hartford, WI 53027 Phone: (262) 670-6488 Fax: (262) 670-6478