Dental Patient Registration

Forms for New Patients

NEW PATIENT ~ ADULT AND CHILD FORMS 

Click HERE to fill out and SUBMIT ONLINE.

The forms listed may be downloaded and completed prior to your appointment.  This will save you time at your first visit.

If you will be using dental insurance, please submit all information at least 24 hours before your scheduled appointment to allow us adequate time to obtain all benefit information.

Click HERE to print forms, fill them out and bring them to your appointment or fax them to us at 281-859-0211.

EXISTING PATIENT 

Click HERE to UPDATE existing patient information and submit ONLINE

“Children under the age of 18, must be accompanied by a parent or legal guardian to ALL DENTAL APPOINTMENTS.”