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Patient Forms

Our new patient exam is complimentary. 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. Information on insurance, FSA or HSA plans you have should also be brought to your appointment. Although we may not be listed as a provider under your insurance, in most cases orthodontic benefits are the same whether the provider is in or out-of-network. We will be happy to check on your benefits for you.


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Amy B. Farnsworth, D.M.D.

  • Amy B. Farnsworth, D.M.D. - 2700 Bardstown Rd., Louisville, KY 40205 Phone: 502-452-2116

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