Patient Forms

Conveniently print your forms online

Our dedicated dental professionals are excited to welcome you to SmilesNY. In order to make your first visit to our practice as pleasant as possible, we encourage you to complete the new patient forms prior to your initial appointment. Not only will this expedite the check-in process, but it also allows you to complete the necessary forms in the comfort and convenience of your own home. Links to all of our new patient forms are included below.

Request a complimentary consultation today.
AT SMILESNY, our New York cosmetic dentists have a patient-friendly philosophy that combines aesthetics, youthful appearances, and a commitment to total oral health. Conveniently located in the heart of New York City, our state-of-the-art facility offers a wide variety of cosmetic, periodontic, orthodontic, restorative, and general dentistry treatments and procedures. Leading New York cosmetic dentists Steven E. Roth D. M. D., Timothy Chase, D. M. D., Kenneth Jackier D. M. D., and Kevin Loshak D. D. S. are dedicated to providing their patients with the highest standard of dental care available.
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220 East 63rd Street, Lobby F, New York, NY 10065

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