Patient Forms

Please take a moment prior to your scheduled appointment in our Houston family, cosmetic & dental implant office to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs.

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New Patient Forms

Patient Registration Form

Notice of Privacy Statement

Hipaa Consent

Existing Patient Forms

If you are an existing patient, we are asking you to fill out an update once a year. We will ask for it on your first appointment of any given year. We are doing this in an effort to keep up with the type and amounts of medicine you may be taking as well as addresses and phone numbers. As of January 2008, we are becoming a paperless office and these forms are scanned in after your appointment. If you have a pre-printed list of medicines already made up, please give it to Traci or Terry at the front desk to be scanned.  Below is a link to the form.  It is provided for your convenience and to help speed up your appointment process. Thank you.

Existing Patient Update Form

Please contact our Houston dental office @ 281-443-7524 if you have any questions or need any assistance. 

 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.