Follow us for more updates

  • Wix Facebook page

Opening hours

Mon, Tues, Thurs: 8am - 5pm

Wed: 10:00am - 5pm

 

Contact us for more information  270.842.3554

© 2015 Destiny Dental. Website development by Licensing Unlimited Media.

PATIENT INFORMATION

Save time at the office and fill out your patient information paperwork ahead of time.

ABOUT YOUR VISIT
Preparation for your appointment

Your comfort and the experience you have at our office is important to us. To help make your check-in process faster and more efficient, please print and fill out the forms below that apply to you. 

 

If you are a new patient, you'll see initial health history, patient information, consent for treatment, and a dental history form below. If you are a returning patient, please use the updated health history form to provide us the most recent information for you. Additional forms can be found if you would like us to provide your information to a third party, or if you would like to assign insurance benefits using our optional forms. Give us a call if you have any questions and we'll be glad to help you prepare for your appointment.

NEW PATIENT

INFORMATION

Please complete the below forms and have them ready at your first appointment for faster check-in.

Patient Information

Initial Health History

Treatment Consent

RETURNING

PATIENTS

If you have visited our office before, please fill out the below so we know your most recent information.

Updated Health History

OPTIONAL

FORMS

If you would like for us to share your records with any third party, please use this form to provide consent.

Consent for Disclosure

Our office will accept assignment of benefits from your insurance company. To initiate, please use the form below.

Assignment of Benefits

TESTIMONIALS

“I travel 60 miles each way to go to Destiny Dental. All the staff are very kind and professional. I get in promptly and receive excellent service. Dr. Davis and staff keep up with new dental research and fully informs me of my options. It's clean and equipment seems like the best and most up to date.”

Peggy B.

“I've introduced six or seven coworkers to Destiny and we have all been pleased with the care we receive at Destiny Dental. The atmosphere is friendly and comfortable, and I never have a problem getting an appointment when I need it. Thanks, everyone!”

Joanna C.

“Always a great experience. Everyone is very friendly and I feel like I am getting the best care for my teeth.”

Miranda S.