Please fill out the form that is best fitting for your appointment type. Filling them out will allow us to attend to your medical needs more quickly than completing them on your arrival. Please make sure to fill out everything so we can better assist you at your dental appointment. Thank you and please call our office if you have any questions at all.
New Patient Adult
New Patient Child
Existing Patient Update
Adult Medical History Update
Child Medical History Update
SRP Consent Form
Consent to treat a minor without parent
We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.
Read what people are saying about us.
Nothing but praise for the entire staff. I've been coming to Kingsland Dental Group for 15+ years.
Dr. Duebbert is the best pediatric dentist. She is so very kind and knows how to make the patient stay calm and like coming to the dentist.:)
I've been coming to Kingsland Dental for 6 years, and I can honestly say from the minute I open the door to the minute I open it back up to leave, I'm treated like I'm special!