photo of a boy grinning bigOur Office Forms

 

For your convenience prior to visiting our office print out the forms and complete the information and bring it with you to your first visit.

 

Each child needs a health history form and a risk  assessment form

 

Health History for Children 3 and Under:

Click here for our Central Office

Click here for our West Office

Click here for our South Office

 

Children 4 and Up:

Click here for our Central Office

Click here for our West Office

Click here for our South Office

 

Each family only needs one HIPPA form and one financial form

 

Click here for HIPPA Form and Financial Policies Form

 

Click here for Notice of Privacy Policies (Read Only)

 

Thanks for your visit!

Please complete our survey!

Click here for Our New Patient Survey

 

To print the form you may need Adobe Acrobat Reader.

 

If you do not have Adobe Acrobat, please click here to download it for free to your computer.

 

 

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texas dental associaiton logo and link american dental association logo and link american assocation of pediatric dentistry logo and link Rita M. Cammarata DDS,  Jennifer P. Kong DDS, Adam C. Shisler DDS MSD and Brenden E. Taylor DDS MSD are Board Certified Pediatric Dentists. ABPD