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New Patient Forms
A little preparation for a more personal visit
Preparing your forms before your consultation helps us understand your history and make the most of your visit.
Every new patient completes one New Patient Form before their first visit to Miso Orthodontic Studio. Adults complete the adult form. For every child and teen, a parent or guardian completes the child and teen form.
The form covers your contact details, insurance information, health and dental history, and a short breathing and sleep screen.
Email your form at least 72 hours before your appointment
- Download the adult form for yourself, or the child and teen form for your child.
- Fill it out on your computer and save it, or print it and complete it by hand.
- Email the completed form to hello@misoortho.com at least 72 hours before your appointment. If you completed it by hand, send a clear photo or scan.
Your form includes your insurance information, which helps us prepare a benefit estimate for your consultation. Please include the subscriber and member information requested in the form and details of any additional dental coverage.
If your appointment is sooner than 72 hours away, please send your form as soon as possible. We may need to follow up with your benefit information after the consultation.
Helpful information to have ready
- Your medication list and relevant medical history.
- Your dental insurance card and subscriber information.
- Your dentist’s name and contact information.
- Information about previous orthodontic care or recent X-rays.
- Any questions you would like to discuss with us.
Please let us know about existing records before arranging new imaging elsewhere specifically for this visit.
Why does the form ask about breathing and sleep?
These questions help us understand your health history and identify concerns that may need follow-up. They are screening questions; completing the form does not diagnose a sleep disorder.4
Need help with the forms?
If you have a question about which forms to complete or how to provide your information, contact our team before your appointment. We will help you prepare for your visit.