Lubbock KIDS Dental
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Patient Forms

Here are a couple of our patient forms for your review. Please download and print form if needed. Do not e-mail completed forms with protected health information. You can bring the form to your appointment of fax the document to 806-744-7241.
You can click on these links to directly fill out a
  • registration form or contact update for a patient
  • medical history for your child.
The information will be directly submitted to our office database. The server is secure (https) and your information is protected.

patient_information_med_history.pdf
File Size: 220 kb
File Type: pdf
Download File

patient_information_med_history_spanish.pdf
File Size: 237 kb
File Type: pdf
Download File

general_consent.pdf
File Size: 368 kb
File Type: pdf
Download File

sedation_instructions.pdf
File Size: 303 kb
File Type: pdf
Download File

notice_of_privacy_practices.pdf
File Size: 59 kb
File Type: pdf
Download File

post_operative_sedation_instructions.pdf
File Size: 208 kb
File Type: pdf
Download File

covenant_surgicenter_instructions.pdf
File Size: 152 kb
File Type: pdf
Download File

lkd__post_surgery_instructions_english_.pdf
File Size: 328 kb
File Type: pdf
Download File

lkd__post_surgery_spanish.pdf
File Size: 216 kb
File Type: pdf
Download File

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