New Patient Forms

New-Patient-Forms |Dr. Mary Kay Becher OrthodonticsIn order to make your first visit with us go as quickly and smoothly as possible, we would ask that you please complete our medical history and patient information paperwork prior to your appointment.

Secure Online Form

We are happy to offer our patients the convenience of a secure online form for entering your medical history and patient information. Please complete all fields and hit the “Submit” button at the bottom.

CLICK HERE | Online Medical History & Patient Information

Printable Forms

If you prefer to use a paper form, please print the following forms and bring them with you to your appointment.  If you cannot print them, please feel free to contact our office at 512-444-6057 and we can send you the forms.

CLICK HERE | Notice of Privacy Practices

CLICK HERE | Patient Information

CLICK HERE | Medical History

CLICK HERE | Acknowledgement of Receipt of Notice of Privacy Practices