Skip to content
ICTeeth Pediatric Dentistry
  • About
    • Meet Our Doctors
    • NE Wichita Location
    • West Wichita Location
    • Smile Safari Derby Location
    • Read Our Reviews
  • Services
    • General Dentistry
    • Sedation Dentistry
    • Dental Sealants
    • Fluoride Treatments
    • Athletic Mouth Guards
    • Special Needs
  • New Patients
    • New Patient Paperwork
    • Finances and Insurance
    • Your Child’s First Visit
    • Referring Doctors
  • Resources
    • Oral Health Education
    • Growth and Development
    • Guidance of Erupting Teeth
    • Preventing Baby Bottle Decay
  • Contact
  • Blog
316-681-3228

New Patient Paperwork

Everything You Need For Your First Visit:

English forms:

  • New Patient Registration Packet

Spanish forms:

  • Paquete de Registro de Pacientes Nuevos

Dr. Stephen P. Moore

Dr. David J. Brown

Dr. Trey K. Anderson

Dr. Amrita Khemka

Dr. Kristal Raya

Dr. Kelsey Martinez

Learn More

Contact Us!

316-681-3228
Contact Us

NE Wichita

2143 N Collective Ln, Ste B
Wichita, Kansas 67206

316-681-3228

Smile Safari

2701 N Rock Road #400
Derby, Kansas 67037

316-681-3228

West Wichita

13610 W. Maple St.
Wichita, KS 67235

316-681-3228

Follow Us

Join Our Team

Apply Now
  • Home
  • About Us
  • Services
  • New Patients
  • Resources
  • Contact
  • Blog

Copyright 2024. All Rights Reserved. Website by Infogenix.