Orthodontic Office Forms

Informative and interactive office forms for McNutt Orthodontics are found on this page. Please do not hesitate to contact us if you have questions or if we can help in any way. Our administrative orthodontic dental team is separate from our pediatric dentistry administrative team.

Below you will find instructions and links to our:

New Patient Registration Form

New Patient Helpful Instructions

  • Completing our online New Patient Registration form in advance is required.
  • Time is not allotted at the consultation for completing the form.
  • In the event you are unable to complete the form at least a day in advance, plan to arrive twenty minutes early in order to complete the form in office on our computer.
  • We may not be able to provide you with accurate orthodontic insurance coverage if you do not provide your information at least 48 hours in advance.
  • To email us a copy of your insurance card or dental records, please send them to [email protected].
  • If a panorex x-ray is available from your family dentist or another orthodontist, please request that the doctor email a digital copy to you or that one be sent directly to us at [email protected].
  • If you have trouble obtaining x- rays or dental records from a previous doctor, please see the Dental Records Release Form section of our website for help.

X-Rays & Radiographs: Panorex

A panorex X-ray is a standard part of most orthodontic exams. Sometimes the general family dentist has already taken one on the patient.

In the event you do not have a direct referral to us from your family dentist, please request a copy of any panorex X-rays one file for the patient.

A high-resolution copy emailed to you can be then forwarded to us. Please contact us here.

  • Please note that by law (NC Board of Dental Examiners), you are entitled to a copy of your X-rays from the family dentist or another orthodontist without having to sign a records release form, as long as they practice in the state of NC.
  • By law, you only need to verbally request (the law does not require you to be in person) a copy, and you can request that it be sent directly to us.
  • In the event that you are told that you or your child’s dental records won’t be released to you without a signed records release form, please understand that this is not legal.
  • For help or more information, contact the NC Board of Dental Examiners.

General Orthodontic Consultation Information

Retainer Repair
& Replacement Form

After we review the form, we will contact you to schedule your evaluation.

New Patient Helpful Instructions

We are routinely contacted by patients we did not treat, most often adults who were treated as teens, requesting an evaluation to repair or replace broken or lost retainers. These retainers include both removable retainers and in-mouth bonded permanent wire retainers.

We are happy to provide solutions for these types of problems, and a particular type of retainer consultation is required.

Please note that we cannot guarantee repair or replacement of a retainer ‘same day’. There are many types of retainers and different types of repairs.

Most removable retainers are replaced by creating a 3D-printed model of your teeth / dental arch. Our clinical orthodontic team uses a scanning device (non-radiologic / no X-rays) to create a computer-generated 3D model of your teeth.

We 3D-print the model and then fabricate the retainer based on the model of your teeth. In most cases, we can provide you with the 3D model for safekeeping, as this model can be used to create additional retainers.

Records Release Form

There are circumstances where the law will require us to use a signed dental records release form in order for our practice to obtain a copy of dental records from another orthodontist, dentist or dental specialist.

In the event you need a copy of our release form to complete and submit to your doctor, use the Records Release Form button above.

Financial & Insurance Policies

To review our Financial & Insurance Policies prior to your initial appointment, please click on and read the document below. We are happy to answer any questions that you may have about our policies and assist you in understanding your insurance coverage.

View Policies