Patient Forms

Covid Pre-Screen

All our forms are now accessed through our patient portal. Please take a moment and contact us to get access.

• Covid-19 Prescreen Form

New Patient Packet

All our forms are now accessed through our patient portal. Please take a moment and contact us to get access.

• Patient Health History
• Patient Information Form
• Dental History Form
• Insurance Information Form
• Communication Release Form
• Authorizations and Acknowledgements Form
• Sleep Apnea Screening Form
• Informed Consent for General Dentistry

Patient Consent Forms

All our forms are now accessed through our patient portal. Please take a moment and contact us to get access.

• Silver Amalgam Restorations Consent Form
• Consent Form for Extraction of Teeth
• Crown and Bridge Consent Form
• General Consent for Treatment and Local Anesthesia
• Root Canal Therapy Consent Form
• Informed Consent for Composite Filling
• Informed Consent for Non-Surgical Periodontal Treatment
• Consent for Final Cementation of Crowns and Veneers
• Informed Consent for Gingivectomy Procedure
• Informed Consent for Soft Tissue Dental Laser Procedures
• Informed Consent for Nitrous Oxide Sedation
• Oxygen / Ozone Therapy Informed Consent

Advantage Program

• Carrollton Smiles Advantage Program