Kimberly Voges, DDS, PA

Family & Cosmetic Dentistry
10350 Bandera Rd, Suite 110
San Antonio, TX 78250
(210) 509-3611

New Patient Forms

For your convenience, you may print out and complete our New Patient forms at home before visiting the dental office. Although not required, bringing completed forms with you will save registration time at your first appointment.

Patient Information Form

You will need this form to provide contact information, insurance information and the reason for your visit. | PDF |

Health History Form

This form is to provide information regarding your health, for example, whether you have any health conditions, illnesses and/or allerigies. | PDF |

HIPAA Consent Form

You may complete this form to allow us to disclose information about you for treatment, payment and insurance purposes. | PDF |

Financial Policy

We ask that all patients read our Financial Policy prior to service. You will need to acknowledge on the Patient Information Form that you have received and read this document. | PDF |

CHIP & Medicaid Patient Information Form

If you may be benefiting from CHIP or Medicaid, this form is to provide us with patient and responsible party information. | PDF |

If you're unable to open PDF files, you need Adobe Reader. It's a free download.

We invite you to experience the best and most comprehensive care available in a comfortable and relaxed environment. If you would like to make an appointment, please contact our office by phone at 210. 509.3611.