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 Dr.Gary L. Geaccone DDS

Family Dental Center & Cosmetic Dentistry in League City

Dental Office Forms:

Many of our patients like to have the forms before coming to our office for their visit so we have provided those forms here should you want to print and complete them and bring them with you to your appointment or just know what you need to bring with you in order to complete them in the office.

Notice of Privacy  -  This is a 3 page notice of your privacy. We will need your initials on 2 of the pages. Please see them all here: Page 1, Page 2, Page 3 

Dental Treatment Consent Form - Should you need in-depth treatment, we will go over a treatment plan for you and will need your consent. Here is that form: Dental Treatment Consent Form. Keep in mind that we have Payment Plan Financing options.

Patient Information Forms - Here are our office patient forms which we ask of all of our patients to complete and bring with them or complete in the office:  Patient Info, Patient History

Thank you for your interesting in scheduling an appointment - please call either of our offices or contact us at one of locations (League City at (281) 332-9565 or Bellaire, Texas at (713) 667-6675)) for further assistance. We look forward to helping you find your smile again!