512-306-8822 |
| We at Periodontal Surgical Arts, believe in the overall welfare of our patients but also advocate doing our part to prevent the spread of COVID-19. Following the mandate from Governor Abbott and the Texas Board of Dental Examiners, we are following distancing guidelines. This includes minimizing the number of patients and team members in the practice at one time. Also, patients are being treated one at a time on a personalized basis. We do require that patients wear face masks and screen themselves prior to visiting. Thank you for your understanding. |
Patient Forms Printable FormsFor your convenience, you may download and complete the following new patient forms (PDF) prior to your first visit. This will save you a few minutes in the waiting room. Patient Registration Form (PDF)
Medical History Form (PDF) HIPAA Financial Consent Form (PDF) HIPAA Form (PDF) These forms utilizes Adobe PDF technology and can only be properly displayed through Adobe Acrobat or Adobe Reader. Please save the file, then view using either of those programs. If you are viewing the PDF inside of your web browser (ie Firefox, Chrome, etc) it may not display properly due to limitations of the built in PDF viewers with the web browsers. Click here to download Adobe Reader |
Dr. David Yu, DDS, MS | Dr. Nicole Litizzette, DDS, MSFax: (512) 306-8848 Monday - Thursday: 7:30am - 3:00pm Friday: 7:00am - 12:00pm |
