FORMS & DISCLOSURES

Our forms and disclosures give us extra information regarding your oral health so that we can provide you with the best dental care in Houston.

PRINT AND BRING
If you are a new patient, download, print, fill out, and bring in the New Patient form so we can jump start the process for making you a part of our family. The Privacy Policy and Financial Agreements should also be signed and brought to us to affirm you have read and understand how we use your information.

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New Patient Form

This form details all of your contact information, emergency contacts, insurance, and medical history. With this, we can accurately and effectively treat and care for your oral health.

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Practice Privacy Policy

The Practice Privacy Policy explains how we use your information and explains your rights as a patient. We don’t disclose your personal medical information to anyone but you.

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Financial Agreement

The Financial Agreement is an agreement between you – the patient, us – the caregiver, and your insurance company. This document explains the ins and outs of financial coverage regarding dental care.