New Patient Forms

We offer our new patient forms online so you can download and complete these forms in the convenience of your home prior to your first appointment. Please call us if you have any questions. (817) 421-4775

All New Patients Must Print and Sign the following:

New Patient Registration Paperwork
(Please print, complete, sign and bring with you to your first visit)

New Patient Consultation Form
(Please print, complete, sign and bring with you to your first visit)

Consent for Treatment
(Please print, complete, sign and bring with you to your first visit)

X-ray Consent
(Please print, complete, sign and bring with you to your first visit)

Office Insurance Policy
(Please print, complete, sign and bring with you to your first visit)

HIPAA Acknowledgement
(Please print, complete, sign and bring with you to your first visit)

Receipt of HIPPA Notice
(Please read)

Auto Accident Paperwork (Please print, complete, sign and bring with you to your first visit)

Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.