3610 Shire Boulevard Suite #200, Richardson, TX 75082 | (214) 572-8633
4323 North Josey Lane, Professional Plaza 1, Suite 103 | Carrollton, TX 75010 | (972) 394-2114

New Patient Information and Forms

Click the below link to complete our new patient registration form.

Important Information About Registration

  • Please allow 15-20 minutes for completing the registration form. Partially completed forms will not be saved and will require you to start over.
  • Please have a list of all medical conditions, current medications including dosages, and allergies, as well as current employer and dental/medical insurance information ready.
  • Please complete all questions and click the Submit button when finished. Wait to see the Thank You/Confirmation screen prior to exiting.
New Patient Registration