Phone: (817) 800-9634 Fax: (817) 549-2060

Patient Forms

Instructions for downloading patient forms

Note: Our forms require Adobe Acrobat Reader. If your computer does not have this software, it is available for free download here:

We have made all of our patient forms available to you in one location as Adobe Acrobat 5 files. For your safety and convenience, we recommend printing and completing these forms in the comfort of your home.

Please remember to bring your completed forms with you for your first appointment. If you have any problem getting these files to print properly, please call our office and we will gladly mail, email, or fax them to you.

Pre-Operative Instructions FormMedical History Update Form Disclosure & Consent Form Post-Operative Instructions Form Acknowledgment of Privacy Practices Form

Miscellaneous forms (if required):

Consent for
Tooth Extraction
Consent for

Consent for
Dental Implant with Grafting
Consent for
Sinus Surgery
Consent for
Consent for

Back to Pre-Operative Instructions

Contact Dr. Starck

(817) 800-9634