Kirklin Family Dentistry
Creating Beautiful Smiles
Call: (806) 435-5335

Patient Forms

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

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.