Minimize Your Paperwork

You don't like to be bothered with paperwork in a dental office. Do it at home instead!

You can fill out the four attached PDF forms (5 pages in all) at your computer, or you can print them and complete them by hand. When you're finished, you can fax them to Dr. Brenke at 623-572-7288 ... or you can bring them with you. You choose.

Patient Registration
Dental Insurance
Legal Consent
Consent Statements

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© 2007-2009. Richard C. Brenke Kidz-R-Kool Pediatric Dentistry, P.C.
7505 W. Deer Valley Rd., Suite 110
Peoria, AZ 85382 623-572-5777