New Patient Forms

We are happy to offer our patient forms online. Please print and fill them out at your convenience before your visit.

New Patient Registration and Medical Dental History Form

Please download, print and complete this form before your first dental appointment.

Click here to download English Form

Click here to download Spanish Form

Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Click here to download

HIPAA Form
Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.
Click here to download

If you are unable to view the PDF files, please click on the icon below to download and install Adobe Reader:

 

Address

2141 E. Arapaho Rd.
Suite #140  Richardson, TX 75081
Between Goodyear And Soccer City

(972) 231-8700

office Hours

Monday: 9am - 6pm
Tuesday: Closed
Wednesday - Sunday: 9am - 6pm