Complete Your New Patient Forms Online

Save time at your first visit! Complete your new-patient registration, health history, insurance information, and consent forms securely from home — no clipboard or waiting-room paperwork needed. It takes about 10–15 minutes.

Choose Your Form

Filling out forms for your child or teen? Use the Child Patient Forms. Completing them for yourself? Use the Adult Patient Forms.

How It Works

1. Pick your form above. Adult patients use the adult form; parents and guardians complete the child form for patients under 18.
2. Fill everything out from home. Registration, health history, insurance information, HIPAA acknowledgment, and signatures — all online, all protected on a secure, HIPAA-compliant platform.
3. Arrive and relax. When you walk in, we already have everything we need.

Questions About Your Forms?

If you have trouble with the online forms, or you’d rather complete your paperwork in the office, no problem at all — just arrive about 15 minutes early and we’ll help you. Call us anytime at (804) 773-4940.

Your information is transmitted and stored securely in compliance with HIPAA. Villa Orthodontics never shares your health information except as described in our Notice of Privacy Practices.