accessibility ACCESSIBILITY

**New Patient Forms**

New Patient Forms - David De La Garza Jr., DDS

 

New Patient Forms

Download, Print & Complete Prior To 1st Visit

          Phone: (210)681-1113  Fax: (210)614-2903 Email: drdaviddelagarza@gmail.com  

 

New Patient Checklist:

1. Bring ID (valid driver's license or military id)

2. Proof of Insurance Card (if applicable)

3. Any dental x-rays taken within the last 6 months (full mouth x-rays series, panograph;if applicable) Please note: you may have a co-payment if x-rays are not covered by dental insurance.

Special Note:As a courtesy, we ask our new patients to arrive at least 30 minutes early to take care of any business matters. You are also welcomed to contact and review benefits with your dental insurance company. All co-insurance payments will be collected on the day of service.

Medical Note: Contact your physican if you have a history of surgical implant within the last 2 years (i.e hip/knee replacement, dialysis or any heart conditions). You may be subjected to preventive precautions for dental cleanings or treatment.


Thank you, from the dental office of Dr. David De La Garza, Jr., D.D.S.

Le damos las gracias, de la oficina del Dr. David De La Garza, Jr., D.D.S.

  

 

 

 

 

 


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Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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