Patient Forms

Help us get to know your child!

Please take a moment and fill out our patient information form. If you have any questions along the way, feel free to contact our practice.

• Patient Form (English)
• Medical History (English)
• HIPPA Form (English)

For Spanish Speaking Patients:

• Patient Intake Form (Spanish)
• Medical History Form (Spanish)
• HIPPA Form (Spanish)

For Orthodontic Consultations

• Orthodontic Consult Form (English)
• Orthodontic Questionnaire (English)
• Orthodontic Consult Form (Spanish)
• Orthodontic Questionnaire (Spanish)

We look forward to meeting you and your little one at your first appointment.

Here are a few extra goodies for your family compliments of Grapevine Kids:

• Fall Bucket List
• Preschool / Kinder mouth buster certificate
• Preschool / Kinder Draw a Tooth Fairy
• Preschool / Kinder Maze Activity Sheet
• Preschool / Kinder Coloring Sheet