Online Patient Registration

Registration and Other Patient Forms

You may preregister with our office by filling out our secure online Patient Registration form, which includes insurance and medical history information. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Clickable button to launch a secure online Patient Registration form

Patient Registration | Save & Exit logo

Note to Patient: There is a “Save and Exit” feature on this form that allows you to complete any portion of this form at a later time before submitting this information to our office.

At a minimum, you will need to input your first name, last name, DOB, email and at least one phone number field (home or cell phone). Once this is filled out, you will notice a button labeled “Save & Exit” appear in the upper right-hand corner of the form. If you choose to select this button, our system will send you a registration email which you can setup and log in at any time to finalize your registration form online.


Downloadable Patient Forms

The following policies and forms are available online for you to review, download, print and complete to bring with you to your first appointment with Dr. Tendler. Please call us for assistance: Tendler Orthodontics Phone Number 561-826-7955.