If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our 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 office if you have any questions at all.
Patient Forms:
Patient Information Form
Medical History
Dental History
Smile Evaluation
Consent Form
Financial Policy
Notice of Privacy
Cancellation and Missed Appointment Policy
Patient Acknowledgement and Consent
Pre-Op Sedation Instructions
Post-Op Sedation Instructions
Send Us A Message
We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.
19 SE 5th Avenue, Perryton, TX 79070
(806) 435-5335
manager@perrytonsmiles.com