Patient Forms

New patient? Please download and fill out the following forms when you come in for your first appointment.

Patient Profile Form

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

Patient Profile Form
Patient Profile
Dr+Epperson+Patient+Profile.pdf
Adobe Acrobat document [92.0 KB]

Financial Policy and Patient Consent Form

Please read over and sign our Financial Policy and Patient Consent Form, acknowledging our payment procedures and privacy policy. This form should also be brought to your first appointment.

Financial Policy and Patient Consent
Payment and Privacy Information
Financial+Policy+and+Patient+Consent+For[...]
Adobe Acrobat document [155.1 KB]

Informed Consent

Please read over and sign our Informed Consent Form, acknowledging our policy for dental treament. This form should also be brought to your first appointment.

Informed Consent
Authorization for Dental Treatment
informed+consent.pdf
Adobe Acrobat document [43.6 KB]

Make an Appointment Today!

 Call us at:

  940-549-2183

 

Twelve Oaks Dental Clinic

 401 Oak St.

 Graham, TX 76450

 Fax: 940-549-4215

 Email:  info@twelveoaksdental.com

 

Use our contact form to get in touch.

Office Hours

Monday - Thursday

8:00 am - 5:00 pm

Friday

7:00 am - 11:00 am

 

Outside our regular business hours, please note our emergency care information.

Keep Your Teeth Healthy!

What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.

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