Patient Forms

We have provided our patient forms online for your convenience. Please fill them out and submit them prior to your appointment with our dentists in Irving, Texas. If you have any questions or if you want to schedule your visit with Dr. Angelie Zamora and Dr. Rebecca Kim, please contact Smiles Family Dental today at 972-444-9337.

View Patient Form

Dental Insurance Form

Medical Hstory Adult

Patient Information Form

HIPAA Acknowledgement Form

Model Release Form