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James Gallagher, D.D.S.
Call:281-361-0102
281-361-0102
281-361-0102
Patient Forms

Patient Forms for Our Kingwood Dental Office

Appointments
Patients are seen on an appointment basis, and we reserve time specifically with you and the doctor or hygienist. We ask that you complete an online appointment request or call in advance so that we may reserve an appointment time for you.

If you are a new patient to our office, the link below contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing forms, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please contact our office if you have any questions at all.

New Patient Forms

  • Welcome Form
  • Medical History Form
  • Medical Consent Form
  • HIPPA FORM
  • Financial Policy Form
  • Smile Evaluation Form :)
  • New Patient Questionnaire Form


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

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