Pediatric Dentists - Burlington & Yanceyville, NC - Roslyn M. Crisp, DDS, MS, PA & Associates

New Patient Forms

Our office, as well as the The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.

The Dental Home is intended to provide a place other
than the Emergency Room for parents.

You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

You may choose whether or not you accompany your child to his/her filling appointment. Although we sense that some children do better without parents present, we are open to having you with your child. If you choose to be present, we suggest the following guidelines to improve chances of a positive outcome:

1. Allow us to prepare your child

2. Be supportive of the practice's terminology

3. Please be a silent observer--support your child with touches

A. This allows us to maintain communication with your child

B. Children will normally listen to their parents instead of us and may not hear our guidance

C. You might give incorrect or misleading information

4. If asked to leave, be ready to immediately walk away

A. Many children will try to control the situation

B. "Acting out" is normal, but unacceptable during fillings

C. This is intended to "short circuit" the control attempt

D. We will continue to support your child at all times

These are very important ways that you can actively help in the success of your child's visit. We are confident that all will go well and hope these guidelines will help prepare you with confidence for the upcoming appointment.

We strive to make each and every visit to our office a fun one!

New Patient Forms:
For your convenience prior to visiting our office, please complete the information in the forms below and bring them with you to your first visit.

Welcome Letter

Medical History for 12 and younger

Medical History for 13 and older

Parent Guidelines

To print the form you will need Adobe Acrobat Reader. If you do not have Adobe Acrobat, please click here to download it for free to your computer.




New Patient Forms Our office, as well as the The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care. The Dental Home is intended to provide a place other than the Emergency Room for parents. You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better. You may choose whether or not you accompany your child to his/her filling appointment. Although we sense that some children do better without parents present, we are open to having you with your child. If you choose to be present, we suggest the following guidelines to improve chances of a positive outcome: 1. Allow us to prepare your child 2. Be supportive of the practice's terminology 3. Please be a silent observer--support your child with touches A. This allows us to maintain communication with your child B. Children will normally listen to their parents instead of us and may not hear our guidance C. You might give incorrect or misleading information 4. If asked to leave, be ready to immediately walk away A. Many children will try to control the situation B. "Acting out" is normal, but unacceptable during fillings C. This is intended to "short circuit" the control attempt D. We will continue to support your child at all times These are very important ways that you can actively help in the success of your child's visit. We are confident that all will go well and hope these guidelines will help prepare you with confidence for the upcoming appointment. We strive to make each and every visit to our office a fun one! New Patient Forms: For your convenience prior to visiting our office, please complete the information in the forms below and bring them with you to your first visit. Welcome Letter Medical History for 12 and younger Medical History for 13 and older Parent Guidelines To print the form you will need Adobe Acrobat Reader. If you do not have Adobe Acrobat, please click here to download it for free to your computer. Back to Top