Patient Forms

Before First Visit

Please assist us by providing the following information before your initial visit:

  • If you have recent x-rays taken less than 1 year ago, please ask your previous dentist to email your x-rays to
  • Please provide our front staff your dental insurance information so that we can have your benefits review prior to your arrival.
  • For Medicaid & TX Chip patients, if Dr. Johnie Nguyen is not listed as the main dentist on your child’s ID card, please call DentaQuest 1(800) 896-2374 or MCNA 1(800) 494-6262 to have the provider Switched.

Day of First Appointment- What to Expect

At Dazzle Dental, we strive to make every dental visit to be a great experience, beginning with the first visit. Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. We’ll get to know you and work with you to set goals to help you achieve a smile that is both beautiful and healthy.

Please arrive at least 15 minutes before your scheduled appointment and plan to spend between 60-90 minutes in our office so we can take x-rays and perform a comprehensive oral exam to determine what services you may need. Your examination will check for signs of:

  • Examining the gums & look for signs of gum disease
  • Check for loose teeth
  • Oral cancer screening
  • Check your bite
  • Look for visual evidence of tooth decay
  • Check for broken teeth
  • Check for damaged fillings
  • Look for changes in the gums covering teeth
  • Evaluate any dental appliance you have
  • Check the contact between your teeth
  • Take X-rays

Your Treatment Plan

Based on the clinical findings of your initial examination, your dentist will customize a treatment plan that summarizes the care you need, which includes the type of cleaning or periodontal therapy that is right for you. Your dental team will review your treatment plan options and recommend a home care routine and any additional follow-up procedures that you may need.

What to Bring

Please be sure to bring the following information to save time during your initial office visit:

  • dental insurance card
  • a photo ID
  • completed new patient forms

New Patient Forms

We make it easy to get started. Please download and complete the forms below and bring them with you to your first visit. If you are unable to complete the forms prior to your visit, plan to arrive at least 30 minutes prior to your scheduled appointment.

Please download Adobe Acrobat below to view/print forms: