New Patient Information

When you call our office to schedule your visit you will need:

  1. The information for the person responsible for the bill, if it is not you
  2. We will need the name and information of whomever is going to be seen at our office.
  3. Their name address and phone number
  4. Their email address
  5. Their date of birth and gender
  6. Concerning the Social Security Number – We will not need your social security number unless you have an insurance carrier that uses this number as your insurance coverage ID. Also if you don’t know who your carrier is, we can look it up under your social security number, so we will only need it for insurance reasons.
  7. How you found out about us. By the way, we appreciate any friends or family members you can send our way.
  8. We will need whatever insurance information you have that you can give us. If you don’t have dental insurance, we have an in-office dental plan that you can still save money on your dental treatment.
  9. If you’d like to complete your dental forms in advance of your visit. Tell us when you call your first time and we will set up your account on our patient portal which gives you access to the dental program that we use at our office. You can complete the forms there.
  10. When you completing your new patient forms, we will need your health history and a list of any medicines you are taking. You will also be required to sign a HIPAA waiver and an Informed Consent for treatment, which lists possible complications that could occur during your dental treatment.
At your first visit you can complete your health history and patient information forms on our Tablet PC in our reception area. It only takes a few minutes, or as said previously you can complete them on our website patient portal in advance of your visit.

FIND OUR OFFICE

Schedule your appointment today!

8301 Whitley Rd
Fort Worth, TX 76148

817-502-1800
office@milesdental.com
Mon – Thurs: 9 AM to 6 PM
Fri – Sat: 9 AM to 1 PM
Sun – Closed