Family Dentist Proudly Serving Dallas, Powder Springs, Hiram, Douglasville, Rockmart, & Surrounding Areas!
  Dallas Family Dentistry  

Patient forms

For your convenience, below are links to patient forms that all new dental patients are required to complete. To download these forms, click on the below links & save the document to your computer. The forms can be filled out in Adobe but you cannot save the form so be sure to print out the form when you are done. Bring the completed forms with you to your dental appointment. We look forward to seeing you!

Adobe Reader is required for the below forms.
Click the below icon to download the free version
.

Dental Patient Registration Form

Patient Health Questionnaire

 
We accept most major insurances including Medicaid & Peachcare!
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