Patient Forms

Resources for New Orthodontic Patients in Fresno, Merced & Los Banos

Thank you for choosing Orthodontics Exclusively to handle your orthodontics and dentofacial orthopedics. Serving patients of all ages in Fresno, Merced, and Los Banos, CA, we use nothing short of the latest technology available to provide each patient with the best treatment possible.

Before your first visit with Dr. Boese or Dr. Boese, Jr., one of our friendly front-office team members will help get you acquainted with the office and some of the customs we practice here. We are well aware that your time is valuable to you, so we highly recommend completing the patient forms before you come in. In order to save you time and effort, we posted our new patient forms below for you to print and complete at your convenience before coming in for your appointment. Simply click on each link and fill out the corresponding information to help us help you.

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*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

Schedule an Appointment Today!

If you have not already, please schedule an appointment to get the ball rolling and we can direct you toward which forms to fill out and bring in. If you have any questions pertaining to portions of the forms, please contact us and we will be happy to guide you through them. Here at our Merced, Los Banos and Fresno orthodontic offices, we are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant. Thank you for your help regarding your orthodontic goals and history, and we look forward to seeing your smile soon!

Merced Office

177 W. El Portal Dr.
Merced, CA 95348

Los Banos Office

820 Iowa Ave.
Los Banos, CA 93635

Fresno Office

373 East Warner Ave., Suite 101
Fresno, CA 93710


We are a preferred provider of Delta Dental of California, Cigna, and Premier orthodontic insurances.

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