• Welcome to our practice! Thank you for scheduling your child at our office. We welcome you to our dental family.

    Below you may access our new patient forms. Please complete a packet for each new patient we will be seeing. The Privacy Health Information (PHI) form can be used after your child's first visit to our office and will be valid for 2 years.  A parent or legal guardian must be present for new patient appointments.  When you arrive for your family’s first appointment with us, we will collect the completed forms and a copy of your dental insurance card. If you don’t have a dental insurance card, please provide a print out from your employers HR or the insurance’s website. To submit a claim on your behalf, we will need, the insurance name, claims address, eligibility phone number, ID and group number.  If your insurance does not provide an ID number,  the policyholder's social security number will be necessary to bill your insurance. 

  • Download, Fill out and Send copies of the New Patient Forms to appts@bayvillagepeds.com

  • New Patient Form

  • 18+ Medical History Update Form

  • Medical History Update Form

  • Records Release

  • HIPAA Authorization

  • Email US

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