Patient Forms

Thank you for choosing West TX Periodontics and Dental Implants, the office of periodontist and dental implant specialist, Dr. Austin Teitelbaum. If you have an appointment scheduled at our office, please download, print and complete the following 3 forms prior to your upcoming appointment. Please bring the completed forms to your scheduled appointment. If you prefer to complete your patient forms in our office, please arrive at least 15 minutes prior to your scheduled appointment to complete the required patient forms. If you have any questions, please contact our office, and our staff would be happy to assist you.

01.Health History

02.HIPAA Notice of Privacy Practices and Acknowledgement of Receipt

03.New Patient Policies

04.Credit Card Authorization Form