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Patient Forms

If you're a new client, please complete the following form and bring it to your first visit to our dentist office.

New Patient Form
Agreement to Pay for Treatment Form
Dental History Form
Medical History Form

If you would like us to coordinate with another dental clinic to request x-rays, please complete this form:

X-Ray Release Form

HIPAA Authorization Form

Note: To download Adobe Acrobat Reader for free, click here

OUR LOCATION

1100 Lomas Blvd NW | Suite 1A | Albuquerque, NM, 87102

HOURS OF OPERATION

Find Out When We Are Open

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Contact Us

Put Your Smile First Today