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Patient Forms for New or Returning Patients

We encourage you to complete your paperwork prior to your visit to our Manchester, CT dentists if possible. Please print, fill out and bring the following forms with you to cut down on your wait time. If you are new to the practice, it is extremely helpful if you are able to have your previous dental office email or send any prior dental x-rays or pertinent information to us that we may need.

Patients Who are Minors:

Attendance by a parent or an arrangement with consent must be made in advance of the appointment. A parent cannot simply drop his or her child off at our dental office and expect care to be given. If you have a teenager who drives and will arrive separately to our office, please let us know ahead of time.


We expect you to take care of your balances at the time of your appointment. We can work with you and contact your insurance company directly to collect payment from your insurance company. Manchester Smiles has financing available, including six months interest-free. Call us to ask for details.

In-Network Insurance Providers:

We are a participating provider for Anthem, BeneCare retiree plan, Husky A/B for children under 21, United Health Care and Delta Dental Premiere.

Set up an appointment today for Manchester Smiles dental practice services!

Your teeth and gums are important parts of your body. At Manchester Smiles, our team of Manchester Smiles dentists share your desire to achieve and keep beautiful teeth and gums — and an overall smile — for your lifetime.

Our Happy Customers

We're here to help you get the perfect smile!
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