Get a head start on your first appointment with Dr. Dale M. Gallagher by completing our new patient forms ahead of time. If you have any questions about these forms or about orthodontics in Austin, Texas, or if you need to schedule a time to visit with our experienced orthodontist, please give our team a call! We always love to hear from you.

Instructions for patient paperwork:
– To fill out by hand
1. Click the link below to download the file.
2. Open the downloaded file and print.

– To fill out electronically
1. Click “Download New Patient Paperwork” to download the paperwork.
2. Once downloaded, open your “downloads” folder on your computer and double click the file “Patient_Paperwork_v2.0.pdf”.
3. Fill out the paperwork and save the file.
4. Email the file as an attachment to info@jawpain.com

Download New Patient Paperwork

Electronic Disclosure of Protected Health Information

HIPPA