Patient & Referral Forms

New patients, please download and fill out the Welcome Packet and New Patient Forms prior to your first appointment. The Notice of Privacy Practices is for your information, but does not need to be returned. Files are in Adobe Acrobat PDF format and may be filled out online using Acrobat. If filing electronically, please save the filled-out PDF file (Acrobat version 7.0 and later required) and email the form to: frontdesk@centexperio.com. Forms that are emailed will require a signature when you arrive at our office. You may also print the forms, fill out and sign, and mail to:

Central Texas Periodontics

Dr. Charles Adamo
8418 Old McGregor Rd.
Waco, TX 76712

Forms must be filled entirely filled out, and signed.

Forms:

 

 

 

 

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