Dallas Dentistry at Its Best - 972-594-4888

Forms and Medical History

New Patient Forms

  • Medical History - This form will contain your address and contact information, as well as a brief medical history.
  • Financial Agreement – This form provides information that includes our payment policies, insurance claims and missed appointments.
  • Acknowledgment of Notice of Privacy Practices – This form provides information about your privacy rights and how we use your protected health information.

Other Forms

Let us hear from you...
Thank you!
To better help you please provide the following information
There has been an error

We're sorry but we could not send your message. Please email us directly at smile@mydfwdentist.com or call us at 972-594-4888

Thank you for your message!