New Patient Information
Dental History and Insurance Form
For your convenience, you may download our new patient form and submit prior to your visit, or bring it with you during your initial consultation.Just select the image to the left and download the form for completion.
Please return to:
Fax: 512-373-3408
Email: smiles@authenticsmiles.com
Tel: 512-330-9403
Cancellation Policy
Authentic smiles kindly requests a 48 hour cancellation notice. Please be advised, a minimum fee of $25.00 will be charged for cancellations within 24 hours.