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PATIENT FORMS · SECURE ONLINE INTAKE

Save twenty minutes of your first visit. Fill the forms out before you arrive.

World Smiles uses a secure online portal for new-patient intake. Three short forms — medical history, dental concerns, and HIPAA acknowledgment — take about ten minutes to complete on any phone, tablet, or computer. Submit them ahead of time and walk into your appointment ready to talk about your teeth instead of paperwork.

HIPAA-compliant About 10 minutes Mobile-friendly
WHAT'S IN THE PACKET

Three forms. About ten minutes.

Everything in the patient packet exists for a reason. World Smiles uses the information directly during your consultation — incomplete records lead to incomplete plans. Here's what you'll cover and why.

Your medical history

Conditions you've been treated for, medications you take, allergies, and any recent surgeries or hospitalizations. Medical conditions affect dental treatment plans, and many medications change what we can prescribe safely. The more complete your history, the safer and more effective your care.

Your dental history and concerns

Past dental work, recurring issues, what's bothering you right now, and what you'd want addressed if everything were possible. This is the form the doctor reads most closely — your concerns drive what we examine first and how we structure your plan.

Consent and HIPAA acknowledgment

Standard consent for examination and HIPAA Notice of Privacy Practices acknowledgment. Reviewed and signed digitally. Required by law for every new patient at any medical office.

WALKTHROUGH

What happens when you click 'Start Patient Forms.'

01

You're routed to our secure portal

The button opens our intake portal in a new tab, hosted by Henry Schein PatientViewer — the same HIPAA-compliant system used by thousands of dental practices nationwide. You'll see World Smiles practice info at the top to confirm you're in the right place.

02

You complete the three forms in order

The portal walks you through each form one at a time. You can save progress and come back later if needed. Most patients finish all three in about ten minutes on a phone, tablet, or computer.

03

Forms submit directly to our office

When you tap Submit, your responses are encrypted and sent to World Smiles' practice management system in real time. You'll see a confirmation screen. We receive them immediately.

04

We review them before your appointment

Your medical and dental history is reviewed before you walk in. By the time you sit down, the doctor is already familiar with your case — which is why your consultation can spend its time on the actual conversation instead of intake.

READY TO GET STARTED

Complete your forms now. Walk in ready.

About ten minutes. Mobile-friendly. Encrypted submission. If you'd rather complete them in the office or by phone, that's fine too — just call us.

Or call 347-378-7827 — we can mail you a paper packet or take your information over the phone.

COMMON QUESTIONS

About our patient forms.

Is my information secure?
Yes. The forms are hosted by Henry Schein PatientViewer, a HIPAA-compliant patient intake system used by thousands of dental and medical practices. Your data is encrypted in transit and at rest. Only authorized World Smiles staff have access to your records.
Can I fill these out on my phone?
Yes. The forms work on any smartphone, tablet, or computer with internet access. Most patients complete them on their phone in about ten minutes.
What if I don't have all the information handy — like a list of my medications?
Save your progress and come back to finish later. If you don't remember the exact name of a medication, write what you know — "the blue blood pressure pill" is more useful than nothing. We'll clarify in the consultation.
Do I have to complete the forms online, or can I do them in the office?
Either works. If you prefer to fill them out in the office, plan to arrive about 20 minutes before your appointment time. If you'd like a paper packet mailed to you ahead of time, call 347-378-7827 and we'll send one.
What if I have records from another dentist — can I just send those?
We need our own forms on file for legal and clinical reasons, but please bring any records you have from previous dentists. Treatment plans, X-rays, lists of past procedures — all of it is useful context, even if it duplicates what's on our intake. Email them ahead to info@worldsmilesnyc.com or bring them to your appointment.
I started the forms but didn't finish. Do I have to start over?
The portal usually saves your progress automatically. If you get logged out, you may need to re-verify your identity to resume. If you have trouble, call us at 347-378-7827 — we can either help you over the phone or have a paper packet ready for you to complete in the office.
WHEN YOU'RE READY

Take ten minutes now. Skip twenty later.

Three forms, encrypted submission, mobile-friendly. Or call us if you'd rather do it by phone.