New Patient Information

Your First Visit

Welcome to Cantrell Family Dentistry! We love working with patients of all ages, and we can’t wait to meet you. The moment you arrive in our office, one of our friendly team members will greet you. Then, we’ll help you finish any of your new patient paperwork before taking you on a tour of our office. We can also introduce you to any of the available staff members at this time. Call if you have questions, or you would like to schedule an appointment with our team. 

Patient Forms

As a new patient, we’d like to welcome you to Cantrell Family Dentistry. You’ll soon feel right at home at our family-friendly practice, and we look forward to getting to know you better. We’ve provided our new patient forms here for you to print, fill out, and bring along to your first appointment. If you would rather fill them out in our office, we will provide these forms for you, but we ask that you please arrive at least 15 minutes prior to your scheduled appointment time to do so.

Adults:

General Consent Medical History HIPAA Privacy Policy HIPAA Consent Agreement Cancellation Policy

Children:
Please print only one HIPPA form for all children

General Consent (one per family) Medical History (one per child) Health Questionnaire (Ages 1 - 4) Health Questionnaire (Ages 5 - 18) HIPAA Privacy Policy HIPAA Consent Agreement Cancellation Policy

Payment Information

As a family dental practice, Cantrell Family Dentistry is committed to making your dental care affordable by offering a variety of payment options. We will work with your dental insurance to maximize your benefits, and we accept cash, check, American Express, MasterCard, Visa, and Discover for payment.

Most Major PPO Insurance Plans Accepted

Our knowledgeable team processes and files claims for most major dental insurance providers in order to ensure you receive the maximum benefit from your coverage. If you have questions about your coverage, please don’t hesitate to ask. We are also in-network providers for many of the popular PPO dental insurance plans including:

Need Financing? We Can Help!

We accept payment for the out of pocket costs of your treatment in the form of cash, credit, and check. If you would like to apply for low or no interest financing, we’re happy to work with CareCredit. Click the link below to apply for pre-approval or ask about CareCredit during your next appointment.

Apply for CareCredit

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456 Country Club Road, Suite 104, Wylie, TX 75098 USA
Dr. Jon Cantrell Dr. Sarah Cantrell Dr. Jon Cantrell and Dr. Sarah Cantrell of Cantrell Family Dentistry offer children's general dentistry in addition to general family dentistry. (972) 442-9139