Patient Forms

You may complete these forms online, where available, or download and print them (Adobe Acrobat Format) to complete at home. Forms that may be completed online require the Adobe Acrobat Reader. To download the free reader, click here: http://get.adobe.com/reader/

If you print the forms to complete at home, please remember to bring them to your appointment. Thank you.

  • Health History and Registration

Complete Online or Download Form

  • Oral Sedation Consent

Download Form 

  • Oral Sedation Patient Instructions

Download Form

  • Smile Evaluation Form

Download Form

  • TMJ Questionaire and Visual Index

Download Form

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Our Office

Dr. Maury Hafernik
11645 Angus Road, Suite 10
Austin, Texas 78759
P: (512) 345-5552

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