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New Patient Forms

New Patient Health History Forms and Instructions:

1. Please select the online forms below (Red Text) and complete your new patient medical & dental history on our secure online site. (Secured by Dental Writer)

2. Please select the link below, print out and complete the additional downloadable PDF forms (Red Text & Numbers).

3. You may Contact Us regarding the forms and your current Xrays.  If you do not have current Xrays, we can provide you with Xrays through our very low radiation, 3 D Cone Beam Scan digital radiographic capability, during your new patient exam and consultation.

4. When we have received your completed forms (either by fax, mail, or through our secure internet site), and Dr. Evans has reviewed them, you will be called for an initial phone interview that will help us evaluate your needs and provide you with: potential- treatment plan options, appointment scheduling, and range of costs.

5. After your phone interview, we will call you to schedule your initial consultation / exam and potential service appointment. Dr. Evans will be able to provide you with a diagnosis and treatment plan only after seeing you in his office for an oral examination/consultation. 

Even after an examination, the full extent of your dental needs may not be completely known.  Some conditions are not visible even with the best xray capabilities.  We look forward to hearing back from you and will be happy to answer any questions regarding the registration and appointment process by calling (903)-825-7400 or send an email on our Contact Us page.   If you do not hear from us within 2 work days please call us, as it is possible that we did not receive your information.

Online forms: Please complete ALL of these forms:

-GENERAL COMPREHENSIVE

-TMD

Downloadable forms: Please download, and complete the Questionnaires listed 3, 4 & 5:

1) Pre and Post Surgical Instructions.pdf

2) Oral Protocol .pdf

3) Mercury Exposure Questionnaire.pdf

4Nutritional Questionnaire.pdf

5) Predisposing Risk Factors Questionnaire.pdf

You may also call our office and have all of the forms faxed or mailed to you.  If you prefer to complete all the forms and fax or snail mail them in, please click on and download the comprehensive forms below:

Comprehensive New Patient Forms.pdf