New Patient Forms at GBPD


Thank you for choosing GBPD for your child’s dental home! In order to provide the best care possible, we require new patients to complete the forms linked below at least 48 hours before their scheduled appointment.  This saves you time in the office and ensures adequate processing time for any insurance information.

Click the New Patient Forms button below when you are ready to begin. We recommend you have your dental insurance card, along with your pediatrician and preferred pharmacy information, available.

You will be guided through two forms: a patient health history form and then a policies form.  All together, these forms will take about 15-20 minutes to complete.

If you need help with completing your forms, do not hesitate to call a GBPD team member at (330) 425-1885 for assistance.

Check-In And Screening At GBPD

When you arrive for your child’s appointment, please remain in your car and text 330-886-4598 to let us know you’re here. You can safely share your child’s name during check-in through this system! This number is also posted outside our office for your convenience when you arrive.

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!

COVID Screening and Safety Measures 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 Upon Arrival

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.

Masks are Still Required Regardless of Vaccination Status

Many of our patients remain too young to receive a Covid vaccination.  Likewise, some of patients and their caregivers have special health considerations that leave them at greater risk for illness.  In order to create an environment that is as safe as possible for all, we kindly ask that all who enter our building wear a mask. Thank you for your cooperation.

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.

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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