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Patient Forms


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For your convenience prior to your appointment, please click on the button below to complete and submit all forms in the package online before your visit.


New Patient Forms Package

Existing Patients


Fill out only at the direction of the office.

Patient Registration
Orthodontic Informed Consent
HIPAA Acknowledgement
Financial Policy
 
 
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Evolution Orthodontics | 2325 Heritage Center Drive, Building 500 Furlong, PA 18925 | 267-544-0297
Evolution Orthodontics
2325 Heritage Center Drive, Building 500
Furlong, PA 18925
267-544-0297
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HOME
  • Home
  • Michael Milewski, DMD
  • Services
    • ← Back
    • View All Services
    • Orthodontic Treatment Phases
    • Clear Aligner Therapy
  • Patient Info
    • ← Back
    • View All Patient Info
    • First Visit
    • Policies
    • Technology
    • Patient Instructions
    • Patient Forms
    • Why Orthodontics
    • First Days in Orthodontic Braces
    • Orthodontic Emergencies
  • Social/Reviews
  • Contact Us
  • Refer a Friend
  • Home
  • Michael Milewski, DMD
  • Meet Our Team
  • Services
  • Patient Info
  • Social/Reviews
  • Contact Us
  • Refer a Friend
  • Request Appointment