NEW Patient Forms at GBPD


We’re delighted you’ve chosen Great Beginnings Pediatric Dentistry for your child’s care! Our practice strives to be a hands-free document office in order to keep our families and team members as safe as possible. This focus means that all forms will be completed digitally BEFORE your child comes in for their appointment.  Please understand that you may be asked to reschedule if your forms are not completed and received in time for the GBPD team to review.

New Patient Forms

Dr. Rachel, Dr. Laura, and GBPD Team always put the health of our patients and community first.  As such, we are helping make office visits as safe as possible by moving all of our patient forms and payment collection operations to digital platforms.

For your convenience, New Patient Forms are available below.

Please be sure to complete both the Health forms and the Consent forms before your child’s appointment. If you have dental insurance, it’s a good idea to have a picture of the card available before starting, as are asked to upload it to the forms.

Returning Patients: Please do not fill out these forms.  You will receive via email different forms based on your child’s history.

We appreciate your commitment to keeping all of us healthy and safe!  Plan 30-40 minutes to complete all of the forms.  We’re here to help you navigate this new, safer way of exchanging forms. Than you for your cooperation.

If you have questions about any of these patient forms, please don’t hesitate to call our office at (330) 425-1885. A team member will be happy to assist you.

We know that there’s a lot of paperwork, but we want to make sure we give your child the best care possible.  The more complete information we have about your child’s health history, the better.  Thank you for your cooperation.

New Check-In And Screening At GBPD

Your health and safety is our top priority. Therefore, we will only be seeing healthy families in the office. If your child and/or someone in your immediate household has a fever, we kindly ask that you reschedule your appointment.

COVID-19 Screening

All patients will be screened upon arrival at the office. Any patient with a fever of 100 degrees or higher will be rescheduled. We kindly ask that no more than the parent/legal guardian/caregiver and the appointed patient come to the office. We will be practicing social distancing and safety guidelines; therefore, there will be no reception area.

Your Car is Our New Waiting Room

In order to help continue social distancing, we are asking all families to remain in their cars upon arrival until invited in by a GBPD team member. Through our text alert system, you will be able to confirm your appointments. 
Also, you are asked to text the number posted on signs outside the building when you arrive.  A team member will respond when you are cleared to come inside the building for your child’s appointment.
Please remain in your car until you receive a text back from our office telling you it’s your time to come in! We appreciate your flexibility and understanding in keeping our office and patients healthy and safe!

Also, we are no longer accepting checks or cash. 

Methods of payment include Apple Pay, Google Pay, HSA and Credit Cards kept on file in your patient chart. 

 If You Opted Out of Texts in the Past

Some of our families responded “stop” to our text system before in order to opt out of text reminders and communications.  If you are one of these families, we urge you to help us opt you back into this system.  To opt back in, please email with your name, cell number you want to opt in with, and a statement clarifying you want to opt in to our text alert system. We suggest that you opt in the phone number of the parent/guardian who will be bringing your child for visits.

For a complete overview of all we’re doing to keep families safe, CLICK HERE.

Great Beginnings Pediatric Dentistry cartoon teeth in logo colors green, purple, blue, and pink

Patient Resources

Looking for a way to encourage good, daily brushing and flossing habits at home? Try our brushing chart!

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