First Visits

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Building Confidence One First Visit at a Time!

We look forward to meeting you and your child in the near future!

Dental visits at an early age are recommended because studies show that cavities are increasing in preschool-aged children. More than 40% of children have “cavities” by the time they reach kindergarten. Tooth decay is considered to be the most prevalent infectious disease of our nation’s young children according to the CDC.
Taking your child to the dentist at a young age can help identify problems before they progress. Parents can receive guidance on how to best take care of their child’s teeth and build good habits. Early regular visits to the pediatric dentist will build a trust that will help young children prepare for a lifetime of good teeth check-ups.
Request an Appointment

Please Fill The Form

Patient Information:

Mother/Guardian

Father/Guardian

Primary Dental Insurance:

Child’s Health History

Please provide the name of any specialty doctors if applicable.

Does your Child Have?

Dental Information

I understand that the information I have given is correct to the best of my knowledge and that it will be held in the strictest of confidence. I understand that the withholding or misrepresentation of medical or dental information can be harmful to my child during treatment. I consent that it is my responsibility to inform the office of any changes in my child’s medical status. I authorize Dr. Nyer, Dr. Zultowsky and their dental team at Bronx Kids Pediatric Dentistry PLLC to take dental radiographs “x-rays” as may be considered necessary by Dr. Nyer and Dr. Zultowsky to diagnose and / or treat my child’s dental problems. I assign Bronx Kids Pediatric Dentistry PLLC all insurance benefits. I understand that I am ultimately responsible for payment of services rendered regardless of insurance benefits. Deductibles and co-payments will be required to be paid prior to commencing dental services.

When Should My Child First Visit the Dentist?

At Bronx Kids we would like to see your child by his or her first birthday. The general rule is six months after eruption of the first tooth as supported by the American Academy of Pediatric Dentistry (AAPD). It is never too late, however, to start educating and acting upon an oral health regiment so please call us today to make your child’s first dental appointment.
In order to save time at your first visit we recommend that you print and fill-out the medical history form below: