Patient Forms

We’re glad you’ve chosen Smiles by Shields as your Jacksonville dentist, and we’re honored to participate in your health and wellness. These forms are provided to help make your experience more pleasant with a shorter wait time when you arrive for your appointment.

Fill out, print, and send us your completed forms at least 2 days before your first appointment. If that’s not possible, plan on arriving about 20 minutes early so you’ll have plenty of time to complete them before seeing Dr. Shields.

Current PatientsNeed to update your health history? Download a new history form to complete before your next visit.

Contact us

Smiles by Shields
3940 San Jose Park Dr.
Jacksonville, FL 32217