To help you prepare for your first visit to Jolley Smiles Orthodontics, we have provided online registration forms for your convenience. We welcome you to complete these forms online or to download, print and fill them out. If you decide to print your forms, please bring them with you to your visit with Dr. Tyler Jolley, Dr. Zachary Pitcher or Dr. Keaton Jolley. If you have questions or concerns about our patient forms, please contact our office. We look forward to your visit with our dentists in Grand Junction, Delta, Fruita and Montrose, Colorado, and Moab, Utah, and we thank you for choosing to learn more about us and the exceptional care we can provide to you or your child.
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Grand Junction Office
New Patient Information
HIPPA Privacy Practices
Informed Consent
Media Release With HIPPA
Medicaid Agreement
Records Access
Delta Office
New Patient Information
HIPPA Privacy Practices
Informed Consent
Media Release With HIPPA
Medicaid Agreement
Records Access
Fruita Office
New Patient Information
HIPPA Privacy Practices
Informed Consent
Media Release With HIPPA
Medicaid Agreement
Records Access
Montrose Office
New Patient Information
HIPPA Privacy Practices
Informed Consent
Media Release With HIPPA
Medicaid Agreement
Records Access
Moab Office
New Patient Information
HIPPA Privacy Practices
Informed Consent
Media Release With HIPPA
Medicaid Agreement
Records Access
