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Surprise (602) 842-4864
Prescott Valley (928) 277-0076
Prescott (928) 443-1200

New Patient Forms
Please print and fill out these forms so we can expedite your first visit:

If you are interested in visiting our office for Sleep Apnea treatment, please download and fill out the questionnaire below:

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
OUR PHILOSOPHY

Our Family Cares for Everyone in Your Family

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Get the Smile You've Always Wanted!

Surprise Smiles
15128 W Bell Rd, Suite 12
Surprise, AZ 85374
(602) 842-4864

Prescott Valley
7136 East Pav Way
Prescott Valley, AZ 86314
(928) 277-0076

Prescott
172 E Merritt St.
Suite F
Prescott, AZ 86301
(928) 443-1200

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New Patient Forms - Surprise, AZ • Surprise Smiles
At Surprise Smiles, we provide new patient forms for our patients to access online. Remember print and fill out those forms, so we can expedite your first visit.
Surprise Smiles, 15128 W Bell Rd, Suite 12, Surprise, AZ 85374-2451 ~ (602) 842-4864 ~ surprisesmilesdental.com ~ 5/9/2023 ~ Key Phrases: Dentist Surprise AZ ~