top of page


Dear Parents,

For your convenience we have provided the necessary Lasky Pediatric Dental Group forms in PDF format  for you to print and bring the filled out copy to your first appointment. You may also use our Online Patient Health History Form. If you first appointment is via Tele-dentistry please email these forms to .   If you have insurance, please don’t forget to bring a copy of your insurance card to the appointment as well.

We look forward to meeting your family and caring for your child. If you have any questions, please don’t hesitate to contact us at 818.465.7545

Thank you,

Lasky Pediatric Dental Group


Online Patient Health

History  Form.

Patient Health

History  Form.

Insurance Form.

bottom of page