Patient Forms

To make an appointment please call our office at (469) 656-4526 or you can make an appointment here.

Secure Online Forms

For your convenience, we offer secure online forms to cut down on the amount of paperwork required during your visit. If you choose to fill the forms out in advance, please select the form you need to complete below:

Patient Information Form:This secure form is for new patients. Please complete this before your first visit if possible.

Annual Medical Update Form:This secure form is for returning patients. Some of your information must be updated every year.

Printable Forms

If you are unable to access the online forms above, we also offer printable forms for your convenience, please bring them to your appointment or fax to us upon completion. Our fax number is 972-612-7842, and our office hours are Monday – Thursday, 7:00 a.m. – 3:00 p.m.

Patient Registration Form

Medical History Form

Consent for Use and Disclosure of Health Information

Acknowledgement of Receipt of Notice of Privacy Practices

Dr. Lee Fitzgerald provides state-of-the-art dental implants and his team can schedule your appointment immediately. His offices are located in Plano, a short drive from North Dallas, Frisco and other parts of the DFW metroplex.