Super Smiles: A fun place for teeth!

Medical History: Online Forms

Medical History
Online Forms
Privacy Notice
Meet the Super Smiles Team
Office Tour
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Gifts of Art
Jokes 4 Kids: by Jenna and Ellie
Crazy Costumes
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CLICK HERE to enter: CHILD Medical History


CLICK HERE to enter: ADULT Medical History

Please note:  When entering your medical history and patient information, there is a default 10 minute timeout after lack of activity.  If a timeout occurs, you will have to restart from the beginning.  We apologize for any inconvenience this may cause.

Super Smiles * 300 N. Aspen * Broken Arrow * OK * 74012
Phone:  918-251-3333
   Fax:  918-251-3339