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Thank you for downloading our forms.

These forms are here for your convenience. You many need to use Adobe Acrobat or Acrobat Reader to fill them out using your computer. Once filled out, you can save the forms to your folder of preference (I like the desktop folder), and either print them out or send them to us electronically..

 

Fax and email is not a secure method of transmission, so if you decide to transmit your information in this manner, you do so at your own risk.

 

Email forms to info@hudsonbenddental.com

Fax to (512)660-6008.

 

New patients will need to fill out forms 1-5.

1. Patient Information

2. Health History

3. HIPPA Notification

4. Office Policy

5. Insurance Co. Information (if you intend on using insurance)

 

If you need to transfer your records to another office, use this form

Form to authorize transfer of dental information

 

If you are a provider, and need to refer a patient to our office for a CBCT xray, use this form

Referral Form for CBCT

 

If you are a provider, and need to refer a patient to our office for an implant, bone graft, or other oral surgury procedure, use this form.

Referral Form for Implant and Oral Surgery