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Lilburn Dacula Gainesville

Patient Forms

We understand it is an inconvenience to fill out paperwork every six months, but it is required so we can recommend the best treatment approach based on each patient’s current health status. Health status and use of medications can change frequently.

It is important for our office to be informed of such changes so we can provide optimal care. We take a personal interest in your health and giving our attention to this very important part of comprehensive patient care. After all, your oral health is connected to overall physical health.

For your convenience, we have provided patient forms below. If you are a new patient, you can complete these forms and turn them in to the office at your child’s first visit, to save on wait time at the office.

Please click the links below to download the patient forms.

We look forward to seeing you!

New Patient Forms

New Patient Form - English
New Multi-Patient Form - English
New Patient Form - Spanish
New Multi-Patient Form - Spanish

Health History Update Forms

Health History Update Form - English
Health History Update Form - Spanish

Additional Forms

dma-635
Patient Authorization To Release Information
Patient Request for Information
caregiver authorization
appointment and payment agreement form english
appointment and payment agreement form spanish
Georgia Department of Public Health Form 3300

Patient Reviews

Average rating for Tebo Dental is 4.75 stars of 5 stars - based on 57 reviews
Glenda R. - Lilburn, GA 30047