Call Us Today
254-231-4948
Call Us Our Location Email Us Schedule Now
  • Home
  • About Us
    • Meet the Doctor
    • Meet the Team
    • Office Tour
  • Services
    • General Dentistry
    • Family Dentistry
    • Restorative Dentistry
    • Root Canal Therapy
    • Wisdom Teeth
    • Sedation Dentistry
    • Dental Crowns
    • Dentures
    • Dental Veneers
    • Teeth Whitening
    • Emergency Dentistry
  • Showcase
    • Smile Gallery
    • Testimonials
  • Patient Info
    • Patient Forms
    • Post Treatment Instructions
    • Notice of Privacy Practices
    • Financial Policy
  • Contact Us
    • Schedule Now
  • Home
  • Patient Forms

Patient Forms

Click a link below to view and download a form.

  • Email Release Form
  • HIPAA Signature Page
  • HIPAA Signature Page (Spanish)
  • MedHx Form
  • MedHX Form (Spanish)
  • Media & Photography Release
  • Media & Photography Release (Spanish)
  • Medical Clearance for Dental Treatment

Contact Us



  • Home
  • Meet the Doctor
  • Meet the Team
  • Office Tour
  • Services
  • Smile Gallery
  • Testimonials
  • Patient Forms
  • Financial Policy
  • HIPAA Patient Privacy Practices
  • Privacy Policy
  • Accessibility
  • Contact Us
QTL Dental © 2019 | Designed by DentalCMO
NagiosCheckValue - Do not remove please