Patient Forms in Tampa, Florida

Request an Appointment

Before coming to our pediatric dental office in Tampa, Florida, we ask that you review and complete the patient forms listed here. At Smile Builders Pediatric Dentistry, we understand how busy you are as a parent. To streamline your visit to our dental office, we have listed our patient forms online. Now you can complete your child’s patient forms from the comfort and convenience of your own home and schedule.

If you have any questions for our dentists and team, we ask that you call 813-880-0100. Dr. Robyn Lesser, Dr. Donna Nichols and Dr. Ashley Tate look forward to caring for your child’s smile!

Online Forms

Please fill out this packet before your child’s appointment!
Pediatric Form Packet – Tampa
Pediatric Form Packet – Dunedin


Downloadable Forms

Is your child coming with someone other than their Parent/Guardian?
View Patient Escort Form

Cool Kids

Smile Stories

5-Star Reviews