Patient Forms

For your convenience, please follow the below steps to complete the new patient forms.

Step 1:
Click on the buttons below and download the forms to your computer.
(IMPORTANT: Do not fill it out online and then download as the filled out information wont be saved when you download and you will need to fill it out again)

Step 2:
Open the forms that you saved on your computer and complete them using Adobe Acrobat Reader or any other similar tool.

Step 3:
After you’ve completed and saved the form, you may print them and bring them to our office on your first visit or email them as an attachment.
For Dallas office: Email to info@blissdentalofdallas.com
For Euless office: Email to info@blissdentalofeuless.com

 

New Patient Form » HIPAA Privacy Form » Consent For Services » Broken or Cancelled Appointments »

 

Important Notice

Dr. Sheth and her office are concerned about your personal and medical privacy. If you choose to email your patient forms to our office, you should be aware that while many top-level email systems are password-protected and secure, not all email correspondence is encrypted and your personal information may be visible to third parties (like your internet service provider, employer or another account user.) If you are not sure about the security of your email account, please bring a printed copy of your forms on your first visit. If you choose to email your forms to Dr. Sheth, she and her staff are trained to manage all patient correspondence and medical information according to HIPAA regulations.