Patient Forms
If you are a new patient or an established patient the links below will direct you to our patient registration forms that you can fill our and submit online to our Orlando dental office prior to your appointment. Thank you and please call our dental office if you have any questions or need any assistance.
New Patients Click Here to access and fill out patient registration forms
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
I have been seeing Dr. Childers for cleanings and procedures for well over ten years. I tell people if I needed to I would drive to Georgia to be her patient! She and her staff are excellent, they make me feel like family and take very good care of me and my dental needs. Dr. Childers is constantly improving her equipment and expanding her knowledge base on state of the art dental procedures. I was referred to Dr. Childers by a well known Orlando pediatric dentist who told me she was who the dentists go to for their own dental work! Julie M. I wanted to write and thank you about my visit yesterday. Thank you for training your staff to be so understanding of those with special needs, everyone made me comfortable and explained all the information very clear. They all went above and beyond just to make me comfy. Thank you for cleaning my teeth and explaining to me how all those machines work. This is great Example of legendary dental skills and service. Sean
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