Registration Forms

Please fill out the following forms, print them out, and bring them with you for your visit to Dr. Rothman's office.

Child's Registration & Medical History (HTML)     (PDF)

Financial Policy (HTML)   (PDF)

Infant Risk Assessment (HTML)   (PDF)

HIPPA (PDF)

Patient Update For Returning Patients (HTML)   (PDF)

Information Sheets For Parents

Welcome To The Office!

Xylitol Fact Sheet

What to Expect at Your Child’s Operative Appointment

Dental Materials Fact Sheet

Tooth Extraction Instructions

First Aid for Dental Emergencies