New Patient Registration Forms | Grapevine, Colleyville, & Southlake, TX Dentistry
For your convenience, our new patient Adobe Acrobat forms are available online for you to complete and print prior to your dental visit. Note: to ensure patient privacy, all social security numbers and signatures are to be completed in office at the time of your appointment. If you would prefer, you may send your completed forms to us directly at hygiene@DFWSmiles.com.
Please Complete and Print ALL 4 Forms Below:
- Patient Registration & Dental/Medical History
- Periodontal Risk Assessment Questionnaire
- Notice of Privacy Practices
- Financial Policy
| All forms require a pdf reader to view. Should you not have one, you may freely download a free copy from adobe.com |  |
Office Information
Enter your description about your detail contact information and address here
- info@dfwsmiles.com
- Phone: 817/281-3444
- Fax: 817/416-6389
- 2700 William D Tate Ave # 100 Grapevine, TX 76051-4346
Testimonials
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I've been meaning to tell you, and your staff, how much I admire your philanthropic efforts throughout the year. You are a terrific group of ...
Sandy – Dec 2011 -
Just wanted to say Thanks for the kind, courteous treatment that I received by all in your office this past Monday. I'm a new ...
Joe – Dec 2011 -
Everyone is your office is extremely friendly. I always feel so welcome and comfortable. Thank you for making dental work a "nice" experience!!
Laura – July 2011 -
I'm not sure that you could make any changes to improve what you have. Your staff is great! They made me feel welcome as soon ...
Russ – July 2011 -
Amanda, Melody, Dr Parker - the three I saw - were friendly and efficient, as usual! I didn't try the new beverage dispenser this time, ...
Sandra – July 2011
