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For Patients

Please print and complete these forms at home before your first appointment. If you need assistance with downloading or printing these forms, please contact our office:

  • Adult Form
  • Child History

For your convenience, our Patient Forms are available for download here in Adobe Acrobat PDF format. The Adobe Acrobat Reader is FREE and can be downloaded by clicking on the icon below.

adobe reader

Erie Orthodontist board of Orthodontics
Erie Orthodontics | American Dental Association

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Erie Orthodontist and Erie Braces
2141 West 8th. Street Erie, PA 16505
PH: (814) 459-2442
FAX: (814) 459-2442
EMAIL: jbensondmd@yahoo.com

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