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Board Certified Pediatric Dentists

  • Diana Capobianco, D.D.S.
  • Todd Lyman, D.D.S.

Locations

  • Bel Air: 410-569-6700
  • White Marsh: 410-697-9000
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New Patient Forms

Dental FormsTo request an appointment for treatment or a consultation, call the Bel Air office at 410-569-6700 or the White Marsh office at 410-697-9000.

Here is a list of the patient forms used by Growing Smiles. If you are a new patient, or, need to provide us with updated information at your child’s next visit, you can download, print, and complete the appropriate forms and bring them with you to your child’s next visit. To read and/or download our Notice of Privacy Practices, please click here or request a copy when you sign in at the office.

New Patients – These forms will be requested prior to your first visit.
Welcome To Our Practice 

Parent Permission Form

Office Policy

Medical History Form

HIPAA Form

Caries Risk Assessment Questionnaire

You must have the free Adobe Reader to view these forms. Get Adobe Reader.

To read and/or download our Notice of Privacy Practices, please click here or request a copy when you sign in at the office.

Insurance and Billing

Growing Smiles participates with and accepts insurance from several insurance providers although the level of coverage varies on the contract with the carrier. Please call the office at 410-569-6700 (Bel Air) or 410-697-9000 (White Marsh) so that we can review your insurance information with you.

 

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