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Home » New Patient Forms

New Patient Forms

If you are new to Shine Dental, please complete the Medical History form and bring the completed form with you to our office on your first visit.

Download English Form
Download Spanish Form

THREE LOCATIONS TO SERVE YOU BETTER

Houston

736 Telephone Rd.
Houston, TX 77023


(713)-926-1212

Baytown

7599 Garth Rd., Ste 800
Baytown, TX 77521


(281)-421-3000

Mont Belvieu

10857 Eagle Dr., Ste A
Mont Belvieu, TX 77523


(832)-307-7997

Dental Health
  • Child Dentistry
  • Dental Dictionary
  • Dental Specialties
  • Oral Hygiene
  • Periodontal Maintenance
  • Prophylaxis (Teeth Cleaning)
General Services
  • Dental Cleaning
  • Dental Checkups
  • Laughing Gas
  • Root Canals
Cosmetic Services
  • Teeth Whitening
  • Braces
  • Crowns
  • Veneers
Restorative Services
  • Bone Grafting
  • Dental Bridge
  • Dental Implants
  • Dentures
  • Mini Dental Implants
  • Partials
About Us
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    • Houston
    • Baytown
    • Mont Belvieu
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