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patient forms

If your child is a new patient to our office, the forms below contain our new patient paperwork that will need to be filled out before you arrive at our office. 

 

Please complete these forms online and they will be sent to the office. Thank you and please call our office if you have any questions!

Fill out forms

patient forms

If your child is a new patient to our office, the links below contain our new patient paperwork that will need to be filled out before you arrive at our office.

 

Please complete these forms online and they will be sent to the office. Thank you and please call our office if you have any questions!

Fill out forms

COVID-19 Consent Form

COVID-19 Pre-Screen

DO'S & DON'TS

helpful tips to make your first visit rock

  • DO
  • Tell your child that they are going to the pediatric dentist to get their teeth counted, probably take some photos (x-rays), and clean their teeth with a very special toothbrush!
  • If you don't know the answer to your child's questions, respond with "I don't know, let's ask Dr. Rubin when we get there!"
  • DON'T
  • Please refrain from discussing any negative dental experiences or dental anxiety you may have in order to ensure a positive experience for your child.
  • Sometimes, in trying to prepare your child for your appointment with us, you may use a scary word when describing what to expect. Let’s avoid using words such as needle, shot, pinch, injection, pull, and pain.

DO'S & DONT'S

helpful tips to make your first dental visit rock

DO

  • Tell your child that they are going to the pediatric dentist
    to get their teeth counted, probably take some photos (x-rays), and clean their teeth with a very special toothbrush!
  • If you don't know the answer to your child's questions, respond with "I don't know, let's ask Dr. Rubin when we get there!"

DON'T

  • Please refrain from discussing any negative dental experiences or dental anxiety you may have in order to ensure a positive experience for your child.
  • Sometimes, in trying to prepare your child for your appointment with us, you may use a scary word when describing what to expect. Let’s avoid using words such as needle, shot, pinch, injection, pull, and pain.
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OFFICE HOURS

Mon: 8am – 5pm

Tues: 8am – 5pm

Wed: 8am – 2pm

Thurs: 8am – 5pm

Fri: 8am – 5pm

 

BOULDER OFFICE

3000 Center Green Dr Ste 215, Boulder, CO 80301

720-927-7625 (ROCK)

rockpediatricdentistry@gmail.com

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BOULDER OFFICE

3000 Center Green Dr Ste 215, Boulder, CO 80301

720-927-7625 (ROCK)

rockpediatricdentistry@gmail.com

OFFICE HOURS

Mon: 8am – 5pm

Tues: 8am – 5pm

Wed: 8am – 2pm

Thurs: 8am – 5pm

Fri: 8am – 5pm

 

QUICK LINKS

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