Northern Smiles Dentistry Patient Forms

Patient Forms

What To Expect

Bright Smiles & Friendly Faces

Your first visit at Northern Smiles Dentistry is a special one. When you walk through the doors of our modern dental facilities you’ll be greeted with a big smile and friendly faces. Our team was hand-selected for their upbeat attitude and professionalism. No matter your background, oral health condition, or previous dental experiences we tailor each appointment to you to provide a family-like experience. We take your satisfaction very seriously at Northern Smiles Dentistry and will do everything we can to make sure that each appointment is a pleasurable experience.

New Patients

Your First Visit

Prior to Your Visit

Please complete your medical history and provide a list of all medications taken. If available, please provide any recent X-rays from other dental providers, as well as your driver’s license and, if applicable, your dental insurance cards/forms.

Note: All patients under age 18 must be accompanied by a parent or guardian during the initial consultation.

During Your Visit

When you arrive for your appointment, we will complete an in-depth medical and dental health history, and will conduct a thorough examination to measure bone loss, loose teeth, bite, TMJ and other signs of periodontal disease. We will also perform an oral cancer screening.

Implant Patients

A 3D CT scan may be recommended for dental implant patients. This scan allows for analysis of available bone, anatomical structures and nerves prior to implant placement, improving the precision and safety of this procedure. A typical dental implant exam lasts about 30 minutes.

Please notify the office if you have a medical condition or concern prior to surgery (e.g. artificial heart valves or joints, heart murmurs requiring pre-medication, severe diabetes or hypertension).

New Patients

Ahead of your initial visit, register below by downloading and filling out the following forms:

Returning Patients

If you are an existing patient and need to update your medical history, please fill out the form below.

Testimonials

What Our Patients Say

We know that finding a new dentist isn’t exactly the easiest process, but we hope that seeing some of our patient reviews and testimonials will shed some light on why we think we are the best dental office in Arizona!

Charles DiStefano
Charles DiStefano
2022-08-11
As I was leaving this office yesterday, I was glad that Dr. Stansberry is younger than I am so hopefully I will never have to find another dentist. The fact that they thrive independently tells you how good he and his staff are. I know how difficult that is in a corporate managed care system. He has helped my wife and I for many years and we both have all our teeth at nearly 70 years old.
Hernan Laurin
Hernan Laurin
2022-02-08
I have been Troy's patient for some years now and by far he's been the best dentist in my life. I have had many type of dental procedures, from simple cleanings to veneers and implants, and every single time he made it easy and comfortable. Dr. Stansberry and his team, one of the best I have ever seen, are extremely professional, cordial, kind and funny. Everyone at Northern Smile Dentistry and Orthodontics are knowledgeable and excited to help you with any questions or concerns you might have. if you are searching for the perfect dentist, you need to call Troy and his team! NOW!
Anne R
Anne R
2021-06-10
Taylor is a great hygienist and she did a thorough job cleaning my teeth. However, they are requiring masks still (which I have no issue with) but there was a staff member not wearing her mask at some points and then not wearing it properly. One of the receptionists made a patient put on their mask but the staff member right behind her wasn’t even wearing hers... it just doesn’t make sense nor does it seem safe.
Justin Philips
Justin Philips
2021-03-09
Been twice and can't express enough how pleasant, professional and pleased I am. I just told my I am looking forward to my next visit. How great is that?
Nikki Schlundt
Nikki Schlundt
2020-11-18
All staff here have been extremely kind, professional, and thorough!
Shayna Raphael
Shayna Raphael
2020-10-29
We have been so happy with Northern Smiles! Our family has been going here for almost 10 years. They have given us great care & always so respectful. Never have made any of our 3 kids uncomfortable. Always open to questions and don't feel rushed. I recommend them all the time. THANK YOU Dr Stansberry!
Pascal Foucault
Pascal Foucault
2020-10-23
Friendly, quick, efficient and convenient. My dentist since I moved to AZ.

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