First Visit To Fort Worth Endodontics
Please assist us by providing the following information at the time of your 1st appointment:
- Your referral slip and any radiographic films if applicable
- A list of medications you are presently taking
- If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
- **Please complete our online HIPAA and medical history forms.
IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian during their appointment.
Please alert the office if you have a medical condition that may be of concern prior to your endodontic procedure. (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)
If your dentist has taken x-rays, please request that they forward them to our office. Additional films will be taken at our facility as needed.
If you have been advised by your physician or dentist to use antibiotic premedication due to a medical condition/joint replacement please make sure you have taken your antibiotic on the day of your appointment. Please visit www.aae.org for further information regarding dental antibiotic premedication. If you have a question regarding premedication, please call our office prior to your appointment.
New To Our Office?
- Schedule An Appointment Online
- New Patient Registration Forms
- Review Our Financial Policy & Dental Insurance Information
- Get Directions to Our Office
- Learn More About Dr. Loeffelholz or Dr. Nieves!