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Dear Parents,

Welcome to the Lasky Pediatric Dental Group.  We are looking forward to providing exceptional oral health care for your children. To save time, we have provided two ways to provide us with your child's health history.  We have an online patient form that you can fill out that will be automatically submitted to us as well as a PDF form that you can fill out and print.  After printing, please bring the filled out copy to your first visit. If you first appointment is via Tele-dentistry please email these forms to

We would like to refer you to our Frequently Asked Questions (FAQs) page for a general idea about our practice and pediatric dentistry. If you have any questions before your child’s first visit or any other issues, please feel free to call us at 818.465.7545.

Thank you,

Lasky Pediatric Dental Group

Online Patient Health

History  Form.


Patient Health

History Form

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