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Patient Forms


If you are a new patient to our Katy dental office, the forms below will need to filled out when you arrive for your first appointment in our dental office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Thank you and please call our dental office if you have any questions or need any assistance. 

Please click on the links below to open and print out these forms.

  1. Patient Information
  2. Notice of Privacy Practices Acknowledgement
  3. Financial Policy
  4. Cancellation Policy
  5. Medical Form 
  6. Informed Consent
  7. Post-Surgical Instructions 
  8. Discharge Instructions After Sedation & Dental Treatment
  9. Endodontic Post Operation Information
  10. Sealant Instructions 
  11. Information Following A Tooth Extraction 
  12. Sedation Information for Patients
  13. Post-Op Root Canal Information
  14. TMD Self-Care Therapies

    Formas en Espanol

  1. Infomacion para el Paciente
  2. Aviso de prácticas de privacidad Reconocimiento
  3. Política Financiera
  4. Poliza de Cancelación
  5. Historia Medica
  6. Consentimiento Informado 
  7. Instrucciones Para Pacientes Que Tienen Un Gran Riesgo De Picaduras
  8. Instrucciones Para Despues de Una Extraccion
  9. Instrucciones Para Despues de Sedacion y Tratamiento Dental 


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 Usted necesitará Adobe Acrobat Reader para abrir estos formularios. Si usted no tiene Adobe Acrobat Reader puede descargarlo      haciendo clic en el logotipo.


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