New Patient Forms

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You may access the following forms to assist us with your care. Please print and fill out the following forms, then bring them to your appointment.

Instructions and other forms:


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

Dr. Lester A. LeBlanc, D.D.S., P.C. | LeBlanc Orthodontics

  • Larchmont Location - 1415 Boston Post Rd., Larchmont, NY 10538 Phone: 914-833-2306
  • Fleetwood Location - 559 Gramatan Ave., Mount Vernon, NY 10552 Phone: 914-668-8880

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