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      • Dr. Pablo Cuevas
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To Our Patients,

We understand and deeply respect that you may be concerned about coronavirus in public places, even at our state-of-the-art sterilized office.

Our first priority is always the health and well-being of our patients. And that is a priority we take extremely seriously, even with the current disruptions we’re all experiencing.

It has been a very difficult decision, but we have decided that it is in the best interest of our community, our team, and our patients that we not see regular patients until further notice.

If you do have a dental emergency, we are here and will be here and happy to help you. Please call us and we’ll get you in ASAP.

If you do have a scheduled appointment, we will be reaching out to you directly to get you rescheduled to a future date.

This is just one more way that we can show our high level of care for you … and for everyone in our community. We very much look forward to seeing you, your family, and your friends very soon.

As always, if you have any questions, please call our office at 203-349-3537.

Sincerely,

Dr. Cuevas
Fairfield Smiles

Contact Us
WE ARE OPEN | Read our COVID-19 Protocols
Call Today203-349-3537 Request an Appointment
Call Today203-349-3537 Request an Appointment
111 Beach Road, 2nd Floor, Fairfield, CT 06824
  • Home
  • About Us
    • Meet the Doctor
      • Dr. Pablo Cuevas
    • Meet the Team
    • Why Choose Us
    • Tour the Office
    • Community Involvement
    • FAQ
  • Our Dental Services
    • General Dentistry
      • Dental Cleanings and Exams
      • Gum Disease Treatment
      • Mouthguards
    • Family Dentistry
    • Cosmetic Dentistry
      • Dental Veneers
      • Teeth Whitening
      • Smile Makeover
      • Tooth Bonding
      • Gum Reshaping/ Gummy Smile Treatment
      • Teeth Contouring/Crown Lengthening
    • Orthodontics
    • Restorative Dentistry
      • Tooth Fillings
      • Root Canals
      • Dental Crowns & Bridges
      • Dentures
    • Dental Implants
      • Same-Day Smile
    • Relieving Dental Anxiety
    • Dental Emergencies
    • Oral Surgery
    • TMJ Treatment/Teeth Grinding
    • Sleep Apnea
  • Patient Testimonials
    • Smile Gallery
  • Patient Resources
    • Specials and Promotions
    • Patient Forms
    • Payment Options
    • I’m Embarrassed To Smile
    • I’m Having Trouble Chewing
    • I’m In Pain Or Have Discomfort
  • COVID-19 Protocols
  • Blog
  • Search
Prepare For Your Visit To Our Fairfield Dentist Office
  • New patients can receive an exam for $97
  • Call for a free dental implants consultation
  • Relax in our comfortable heated chairs

Schedule An Appointment With Your New Dentist!

203-349-3537
Request an Appointment

We can see you as soon as tomorrow!

Home > Patient Resources > Patient Forms

Patient Forms

Below you will find Fairfield Smiles By Design’s new patient forms. These are the forms you will be required to fill out at your first visit to our office. To expedite the sign-in process and to help your first visit go more smoothly, please fill out the forms using the provided links before your appointment.

If you have any questions or need help filling out the forms, please contact our Fairfield, CT dentist office. A member of our staff will be glad to assist you. We can be reached by phone at 203-349-3537.

  • Notice of Privacy Form (HIPAA)
  • Fill Out Your New Patient Forms Online Here

What Our Patients are Saying

D. C. (Verified Patient) | Jan 02, 2021
5
Erin is an amazing dental hygienist.

Erin is an amazing dental hygienist.

H. S. (Verified Patient) | Dec 11, 2020
5
Dr. Cuevas is an excellent dentist! I have the utmost of confidence in him and...
Read More

Dr. Cuevas is an excellent dentist! I have the utmost of confidence in him and his staff. Always treated well.... Erin does thorough cleaning and makes the experience pleasant. I have been a patient there for at least 15 years and always feel completely satisfied by the care I receive. Highly recommend for top quality dental care!

H. S. (Verified Patient) | Dec 11, 2020
5
Dr. Cuevas is an excellent dentist! I have the utmost of confidence in him and...
Read More

Dr. Cuevas is an excellent dentist! I have the utmost of confidence in him and his staff. Always treated well.... Erin does thorough cleaning and makes the experience pleasant. I have been a patient there for at least 15 years and always feel completely satisfied by the care I receive. Highly recommend for top quality dental care!

M. T. (Verified Patient) | Dec 10, 2020
5
Staff friendly & knowledgable. Always get competent service from Dr Cuevas and Erin , my...
Read More

Staff friendly & knowledgable. Always get competent service from Dr Cuevas and Erin , my hygenist!! And they adhere to scheduled appointments..

C. T. (Verified Patient) | Nov 20, 2020
4
The dentist there is a really nice, warm chap and the staff are professional and...
Read More

The dentist there is a really nice, warm chap and the staff are professional and equally welcoming - BUT - and this may be a US dentist thing, $365 (after insurance) to glue a bridging crown back in, seems wildly excessive to me - so I bought some dental cement from Amazon for $40.

O. P. (Verified Patient) | Oct 19, 2020
5
Great practice.

Great practice.

O. P. (Verified Patient) | Oct 19, 2020
5
Great practice.

Great practice.

L. A. (Verified Patient) | Oct 14, 2020
5
Outstanding service by Erin. Very thorough and professional in every way!

Outstanding service by Erin. Very thorough and professional in every way!

L. A. (Verified Patient) | Oct 14, 2020
5
Outstanding service by Erin. Very thorough and professional in every way!

Outstanding service by Erin. Very thorough and professional in every way!

J. P. (Verified Patient) | Oct 02, 2020
5
Dr Cuevas is a pleasure to deal with. Takes good care of you. So does...
Read More

Dr Cuevas is a pleasure to deal with. Takes good care of you. So does his staff. Recommend to all.

Read Our Patient Testimonials
Rate Us
Call Today to Make an Appointment 203-349-3537 Request An Appointment
111 Beach Road, 2nd Floor, Fairfield, CT 06824
  • Mon: 8am-5pm
  • Tue: 8am-5pm
  • Wed: Closed
  • Thu: 8am-5pm
  • Fri: 8am-5pm
  • Sat: By Appointment
  • Sun: Closed
Call Today to make an Appointment 203-349-3537 Request An Appointment

Location

111 Beach Road, 2nd Floor, Fairfield, CT 06824

Office Hours

  • Monday 8am-5pm
  • Tuesday 8am-5pm
  • Wednesday Closed
  • Thursday 8am-5pm
  • Friday 8am-5pm
  • Saturday By Appointment
  • Sunday Closed

Latest Blog Articles

New Patients Receive a $97 Exam & Cleaning

At Fairfield Smiles by Design, we make it as easy as possible for you to take a proactive approach to your oral care. ...

Read More
Top 5 Reasons to Improve Your Smile This Year

Whether you’ve already downloaded that fitness tracker app or aren’t even thinking about a New Year’s resolution, ...

Read More
Call Today to make an Appointment 203-349-3537 Request An Appointment

Location

111 Beach Road, 2nd Floor, Fairfield, CT 06824

Office Hours

  • Monday 8am-5pm
  • Tuesday 8am-5pm
  • Wednesday Closed
  • Thursday 8am-5pm
  • Friday 8am-5pm
  • Saturday By Appointment
  • Sunday Closed

Latest Blog Articles

New Patients Receive a $97 Exam & Cleaning

At Fairfield Smiles by Design, we make it as easy as possible for you to take a proactive approach to your oral care. ...

Read More
Top 5 Reasons to Improve Your Smile This Year

Whether you’ve already downloaded that fitness tracker app or aren’t even thinking about a New Year’s resolution, ...

Read More
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