SAVE TIME. COMPLETE THE FORMS BELOW & BRING TO YOUR APPOINTMENT

To download and print, please click the link below.


Also bring your insurance card.
If you have dental insurance but don’t have your card make sure to bring the name of your insurance carrier, your group number and the 1-800 number so we can verify. If someone other than yourself is the subscriber for the insurance, please bring their information. (We will need the social security number and date of birth of the subscriber). We will make every effort to verify your dental insurance prior to your appointment time.

CONTACT US: 817.339.6288








8731 Benbrook Blvd.
Benbrook, Texas 76126

8731 Benbrook Blvd, Benbrook, Texas 76126