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) |
| HIPAA Notice (English) - not necessary to print |
| HIPAA Notice (Spanish) - no es necesario imprimir |
| HIPAA Acknowledgement (English/Spanish) |
| Office Policy (English) |
| Office Policy (Spanish) |
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) |
| Treatment Consent (Spanish) |