Patient Forms

Online Form

You may access the following forms to assist us with your care. Please complete the following form, and click the "Submit" button at the bottom of the form.


**We are committed to keeping your personal information secure. This online form is submitted via a secure connection and is HIPAA compliant.


Printable Forms

You may access the following forms to assist us with your care. Please print and fill out the appropriate forms, and bring it to your appointment.

Pediatric Dentistry Form

Orthodontic Form


*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

Double-T-Smiles Pediatric Dentistry and Orthodontics

  • Double-T-Smiles Pediatric Dentistry and Orthodontics - 6102 82nd St., Suite 2, Lubbock, TX 79424 Phone: 806-792-2288 Fax: 806-792-2768

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