Patient Forms

Thank you for choosing Blue Wave Orthodontics. We look forward to your visit. To schedule an appointment, please call our office at (914) 967-2277 in Rye, NY,  or  (203) 202-7610 in Darien, CT, or request an appointment online.

Once you have made your initial appointment, you can pre-register by clicking on the links for New Patient Forms below. Our interactive forms are secure to protect your privacy. Simply complete the information and submit. As an alternative, you may download, print, and complete the forms prior to your arrival. This helps to speed up the new patient registration process and gets you in to see the orthodontist faster!

Downloadable Form

• New Patient Information & History Form - Adult
• New Patient Information  & History Form - Child

Secure Interactive Form

• Online Patient Information & Health History Form 

Please note: It may take a few minutes to load the forms if you are using a dial-up Internet Connection. If you are unable to view the forms, you may need to download Adobe Acrobat free by clicking on the icon below. 

If you register online, all of your information is transmitted securely and is held in strictest confidence, adhering to HIPAA Guidelines and protecting your privacy. You will need to print out a copy of the Privacy Policy, sign it, and bring it to your office visit.

Blue Wave Orthodontics has 2 convenient locations serving the areas of:

New York:  Armonk, Bedford, Harrison, Hartsdale, Katonah, Larchmont, Mamaroneck, New Rochelle, Port Chester, Purchase, Rye, Rye Brook, Scarsdale, South Salem, White Plans and West Chester County.

Connecticut:  Cos Cob, Darien, Greenwich, New Canaan, Norwalk, Rowayton, Stamford, Westport, Wilton, Southport, Fairfield and Fairfield County.