Forms to bring to first visit: Medical History, HIPAA Acknowledgement, Office Policy.
Please note that all forms must be signed by a parent or legal guardian (or patient, if over the age of 18). The Medical History form has a space for the parent/guardian to give permission for other individuals to bring the child to dental appointments after the first visit. Please call our office at 214-585-0268 if you have any questions or need assistance to complete the forms.
Please note that all forms must be signed by a parent or legal guardian (or patient, if over the age of 18). The Medical History form has a space for the parent/guardian to give permission for other individuals to bring the child to dental appointments after the first visit. Please call our office at 214-585-0268 if you have any questions or need assistance to complete the forms.

Medical History (English/Spanish) | |
File Size: | 106 kb |
File Type: |

HIPAA Notice (English) - not necessary to print | |
File Size: | 144 kb |
File Type: |

HIPAA Notice (Spanish) - no es necesario imprimir | |
File Size: | 232 kb |
File Type: |

HIPAA Acknowledgement (English/Spanish) | |
File Size: | 38 kb |
File Type: |

Office Policy (English) | |
File Size: | 24 kb |
File Type: |

Office Policy (Spanish) | |
File Size: | 41 kb |
File Type: |
Consent forms for patients returning for dental treatment. Must be signed by a parent or guardian (or patient, if over the age of 18).

Treatment Consent (English) | |
File Size: | 50 kb |
File Type: |

Treatment Consent (Spanish) | |
File Size: | 62 kb |
File Type: | consentsp |
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