Patient Forms

We want your visit to Whittingon Pediatric Dentistry to be as comfortable and convenient as possible, so we’ve provided these patient forms for you to fill out online. We look forward to serving you!

New Patient Form - Child

Additional Patient Form

Now Accepting Insurances

We accept all PPO insurance plans to help make dental care affordable for you. The following are the insurances we are currently in-network with:

Cigna
- DNSP Plans
Aetna
- PPO I & II Plans
Careington
Blue Cross Blue Shield Tx
- DNOA Plans
United Healthcare
Sun Life
United Concordia
- Alliance Plans
And many more!

Need to make a payment?

Click below to use our secure online payment server.

Secure Online Payment