Dr. John and Daniel Scott, DDS
Cedar Creek Smiles in Seven Points, TX
New Patient Forms New Patient Form

he New Patient form is in PDF format, which can be read using Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, get a free copy by clicking on the link below.

Get Adobe Reader

When you have Acrobat Reader, click on the link below to download the New Patient form. (If you are on a dial-up modem connection, please be patient - it may take several minutes). Then print the form, fill it out, and bring it with you on your first visit. Also, after reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it, and bring it in, too.

PDFAdult Form

PDFChild Form

Acknowledgement of Receipt of Notice of Privacy Practices (web page)