Please complete our patient forms before your appointment with our orthodontist. Filling out your paperwork in advance helps us keep Dieguez Smiles running smoothly and on-schedule. If you need help with your forms or have any questions, we invite you to contact our practice at 205-980-4744 (Oak Mountain) 205-785-3179 (Fairfield). We will be happy to assist you!

Online Patient forms:
In order to submit the online forms you must use the Google Chrome web browser. Click here to download.
New Patient Adult Form
New Patient Child Form

Forma para Adultos en Espanol
Forma para Ninos en Espanol

About
Dr. Dieguez

MEET THE DOCTOR

New Patient
Forms

VIEW OUR FORMS

Complimentary
Consultation

REQUEST APPOINTMENT
Translate »