(813) 296-2366

Patient Forms

Going to the dentist can be an overwhelming experience, especially on your first dental visit. Let us put your concerns and anxieties to rest. Our goal at Modern Day Smiles is to make every patient experience as comfortable as possible.

To make your visit as pleasant and brief as possible, there are a few things you should bring with you. Please bring any dental X-rays from the last six months to your first appointment.

With just a few simple forms, we’ll ask for relevant medical history, any medications you might be taking, your dental history, and any dental insurance coverage you may have.

Want to get a head start? Download the new patient forms below.

These documents are in Adobe PDF format. If you’re unable to read PDF files, please  download free Adobe Acrobat Reader here.

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Our Happy Patients

"Excellent Dentist! Excellent customer service! My 89 year old grandmother appreciated the extra care the staff gave to her."

Akhil P.

"Been going to Dr. Lee and staff for over 13 years now and have not had one bad experience. They went above and beyond to get stains off of my teeth. Very clean and relaxing atmosphere."

Chris L.

"I’ve had nothing but pleasurable experiences with the staff at this office. They are always attentive and give great recommendations on treatments that one needs to get done. I wouldn’t want to go to another office and I would recommend this office to anyone."

Melina Q.
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