Puntillo Orthodontics, PC

Crown Point
1549 S. Court St., Suite A
Crown Point, IN 46307
219-662-2264


Schererville
1000 Caroline Ave
Schererville, IN 46375
219-322-8552


Merrillville
200 West 84th Dr.
Merrillville, IN 46410
219-769-7447
Visit us on Blogspot Watch us on YouTube Find us on Facebook
  • Patient Login
  • Doctor Login
invisalign suresmile

Online Health History Forms

Your First Visit | Financial Information | FAQs | Office Tour | Treatment Options
Online Health History Forms | Comment Form

Please take a minute to print and fill out the patient information form before your first appointment:

» Online Health History Form
» Paper Health History Form [PDF]

If you're unable to open PDF files, you can get Adobe Reader® for free.

Back to top

  • Meet the Team
    • Meet Dr. Puntillo
    • Meet Dr. Crane
    • Meet the Team
  • For New Patients
    • Your First Visit
    • Financial Information
    • FAQs
    • Office Tour
    • Treatment Options
    • Online Health History Forms
    • Comment Form
  • About Orthodontics
    • For Children and Adults
    • Why Braces
    • Two-phase Treatment
    • Ortho Dictionary
  • Braces 101
    • Life with Braces
    • Types of Braces
    • Braces Diagram
    • Brace Painter
    • Types of Appliances
    • Retainer Instructions
    • Color Your Retainer
  • Orthodontic Treatments
    • Common Treatments
    • Surgical Orthodontics
    • TMJ/TMD
    • Dentofacial Orthopedics
    • SureSmile®
    • Invisalign®
    • Invisalign® Teen
  • First Aid
    • Emergency Care
    • Patient Care Videos
    • Palatal Expander
  • Contact Us
    • Crown Point Location
    • Schererville Location
    • Merrillville Location
    • Refer a Friend
    • Appointment Request
    • Office Hours
    • News and Events
  • Home

Patient Login | Doctor Login | Meet the Team | For New Patients | About Orthodontics | Braces 101
Orthodontic Treatments | First Aid | Contact Us | Home | Site Map

Orthodontic Web Site by Sesame Design™