Save Time! Complete Your Patient Forms Online Before Your Appointment

Coastal Kids Dental & Braces is proud to be paper-free! Join our efforts to be ultra efficient with time and resources by using our HIPPA-compliant, secure server to complete and submit your Patient Forms directly. After you have scheduled an appointment, please complete and submit your child's personal and Insurance information here.

Only one form per family required.

DO NOT PRINT your completed patient forms or bring them to your first appointment. After you submit your patient forms, they are sent directly to our server. You'll have the opportunity to review and modify them on our reception Kiosk computer before your first appointment. Schedule an appointment here or call 843.818.KIDS (5437).