Patient Forms | Super Smiles for Kids | Dentistry for Infants, Children, & Adolescents

Patient Forms

A group of children are sitting on the floor with their arms in the air.

To help prepare for your first visit to Super Smiles for Kids as a new patient, we have included the following forms that you can print and fill out prior to visiting:

NEW PATIENT FORM

CONSENT AND ACKNOWLEDGEMENT FORM

DENTAL/MEDICAL HISTORY FORM

HIPPA NOTICE FORM

FINANCIAL POLICIES FORM

NEW FORM

Phone: (806) 581-4180 | Fax: (806) 255-8122

Address: 1900 Coulter St Suite G, Amarillo, TX 79106