--- title: "Patient Forms" description: "New patient forms for Green Apple Pediatric Dentistry in Austin — complete them before your child's first visit to save time in the office." canonical_url: "https://greenappleatx.com/patient-forms/" markdown_url: "https://greenappleatx.com/patient-forms.md" site_name: "Green Apple Pediatric Dentistry" lang: "en-US" type: "WebPage" date_published: "2020-12-15T01:29:44+00:00" date_modified: "2026-04-02T21:57:06+00:00" image: "https://greenappleatx.com/wp-content/uploads/2026/04/green-apple-pediatric-dentistry-hero-austin.jpg" generator: "md4wp/3.0.7" builder_detected: "generic" content_source: "page" --- PATIENT INFORMATION # Patient Forms Please click the corresponding (package) link below to fill out your new patient information form. Forms ## New Patient Forms **Only fill out your appointment's specific package.** **Please fill out forms using a computer or tablet. Forms completed on a mobile device may not be received.** Our system requires for each form to have the patient's name at the beginning of the form. [ ### New Patient Forms Complete these forms for your child's first visit to Green Apple Pediatric Dentistry. Open Form ](https://yapi.me/co?m=4n2ps7499jz7s) [ ### Newborn Frenectomy Forms Specific forms for infants requiring tongue-tie or lip-tie release procedures. Open Form ](https://yapi.me/co?m=sq39n6qu7s280) [ ### Child Frenectomy Forms Forms for older children needing frenectomy procedures. Open Form ](https://yapi.me/co?m=clzgc4w8wbp2g) Formas ## Formularios en Español [### Formas para pacientes nuevos Formularios para nuevos pacientes Abrir Formulario](https://yapi.me/co?m=4n2ps7499jz7s) [### Frenectomia Bebe Formularios para frenectomía de recién nacidos Abrir Formulario](https://yapi.me/co?m=sq39n6qu7s280) [### Frenectomia Niño Formularios para frenectomía infantil Abrir Formulario](https://yapi.me/co?m=clzgc4w8wbp2g) Additional Forms ## Other Useful Forms [ ### Non-Parent Consent Form For when someone other than the parent brings the child to the appointment. Open Form](https://yapi.me/f/view.php?id=2144974&document=OxYgenAuthorizationforotherthanthelegalguardiantoconsenttreatment&guid={BC447BEF-7796-471D-B119-12572F08DC99}&lan=English) [ ### Dental Records Release Request to transfer dental records from another provider. Open Form](https://yapi.me/f/view.php?id=2152244&guid={BC447BEF-7796-471D-B119-12572F08DC99}) [ ### Frenectomy Referral Form For referring healthcare providers sending patients for frenectomy procedures. Open Form](https://yapi.me/f/view.php?id=2193816&document=OxYgenFrenectomyReferralForm&guid={BC447BEF-7796-471D-B119-12572F08DC99}) For Healthcare Providers ## Referral Forms [1 Dental Professional Frenectomy Referral Form ](https://yapi.me/f/view.php?id=2502055&document=OxYgenDentalProfessionalFrenectomyReferralForm&guid={BC447BEF-7796-471D-B119-12572F08DC99}) [2 Myofunctional Therapist Frenectomy Referral Form ](https://yapi.me/f/view.php?id=2502070&document=OxYgenMyofunctionalTherapistFrenectomyReferralForm&guid={BC447BEF-7796-471D-B119-12572F08DC99}) [3 Pediatrician Frenectomy Referral Form ](https://yapi.me/f/view.php?id=2502082&document=OxYgenPediatricianFrenectomyReferralForm&guid={BC447BEF-7796-471D-B119-12572F08DC99}) [4 Speech Therapist Frenectomy Referral Form ](https://yapi.me/f/view.php?id=2502094&document=OxYgenSpeechTherapistFrenectomyReferralForm&guid={BC447BEF-7796-471D-B119-12572F08DC99}) 5 Lactation Consultant Frenectomy Referral Form Coming soon — please call our office for this form in the meantime. 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