New Patient Forms

Our New Patient Forms

Here are links to our patient forms. In order to begin your dental visit as quickly as possible, these forms should be filled out before your first visit. If you have any questions, please contact us. 

New Patient Forms

Patients may read and/or fill out the information in advance if preferred. We also provide copies of this form at our offices. Select the link to your preferred Jamboree location.

North Freeway – Link to the new patient form >

Telephone Road – Link to the new patient form >

Willow Chase – Link to the new patient form >

FM 1960 – Link to the new patient form >

Bissonnet – Link to the new patient form >

Authorization for Minor Treatment (PDF)

This form authorizes a parent or guardian to take full responsibility for the child patient and future treatment decisions.

Authorization for Minor Treatment >

Español | Nuevo Formulario Paciente (PDF)

Los pacientes pueden leer y / o completar la información de antemano si se prefiere. También proporcionamos copias de este formulario en nuestras oficinas. Escoga el formulario de su oficina preferida.

North Freeway – Enlace para el formulario >

Telephone Road – Enlace para el formulario >

Willow Chase – Enlace para el formulario >

FM 1960 – Enlace para el formulario >

Bissonnet – Enlace para el formulario >

Español |Formulario de Consentimiento de los Padres

Este formulario autoriza a un padre o tutor para asumir la plena responsabilidad del paciente infantil y las decisiones de tratamiento en el futuro.

Formulario de Consentimiento de los Padres > 

Dentist-20

Meet Our Doctors

Our pediatric specialists and staff love children and are specially trained to put them at ease. We teach your children the proper way to take care of their teeth; but just as important, they learn that going to the dentist can be fun.

We Love Hearing From Our Patients

Testimonials

Positive Feedback & Testimonials

5 Amazing Locations in Houston, TX

North Freeway Office

Phone

Address

Hours

Telephone Rd Office

Phone

Address

Hours

Willow Chase Office

Phone

Address

Hours

FM 1960 Office

Phone

Address

Hours

IMG_20201122_130730770_HDR

Bissonnet Office

Phone

Address

Hours

¡Se Habla Español! We Accept Medicaid!