PRACTICE NAME - Lewisville, TX

PATIENT CENTER

Patient Registration

You may preregister with our office by filling out our secure online Patient Registration form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information.

If you have an electronic version of your medical or dental health card, you may upload it to us securely after you Submit your completed Patient Registration form.


On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

COVID-19 Questionnaire

Please do not fill out until the day before your your appointment

Please fill out our secure online COVID-19 Questionnaire Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Truly bespoke treatment awaits.

Reserve your consultation with Dr. Martin today.

    I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.