Patient Resources

New Patients

Welcome to our office. We are pleased you have chosen Cox & Miranda DDS to service your dental needs. Please click on the following links to print your new patient forms. Please either bring your completed forms the day of your appointment or email the completed form to schedule@coxmiranda.com. In addition, be sure to bring your current insurance information to your appointment.

Please arrive 10 minutes prior to your scheduled appointment time. This will allow us to complete the registration process in a timely manner. If you have had x-rays taken at another provider within the last two years, please contact your previous dental office to have them email digital files to schedule@coxmiranda.com. If you have not had x-rays taken within the last two years, or if your x-rays are not forwarded to our office in advance of your appointment, it is our policy to take them during your initial examination. We will make every effort to accommodate your scheduling needs, and we ask that you help us by keeping your scheduled appointments on time or by notifying us at least one business day in advance if you are unable to do so.

Communication Preferences

Our appointment system allows for appointment reminders and confirmations via email messages, and via text messages to your mobile phone. We call patients with unconfirmed appointments a day in advance of the appointment. If you would like to opt out of any of these communication methods, you can update your preferences by letting the receptionist know at your appointment, calling, or emailing us at schedule@coxmiranda.com.

Change of patient information

If you have a change in your personal information (name change, address, phone number, email address, or insurance plan) please print and complete the following form with the new information. Please bring the form to your appointment, or email it to us at schedule@coxmiranda.com. We will update your records and ensure your information is current.


Communication Preferences

Our appointment system allows for appointment reminders and confirmations via email messages, and via text messages to your mobile phone. We call patients with unconfirmed appointments a day in advance of the appointment. If you would like to opt out of any of these communication methods, you can update your preferences by letting the receptionist know at your appointment, calling, or emailing us at schedule@coxmiranda.com.

Request for Records

Current patients in need of their dental records or x-rays due to a change in provider will need to complete the following release form. Please complete the form in its entirety and include contact information for the new provider, and email the form and your request to schedule@coxmiranda.com. Please allow a minimum of 3 business day's notice when requesting records.




Forms

Insurance consent forms.pdf Mar 22, 2018 11:51 PM
Notice of practice privacy.pdf Mar 22, 2018 11:54 PM
Medical History.pdf Mar 22, 2018 11:54 PM
hippa2.pdf Mar 22, 2018 11:55 PM
Facts_Materials_English.pdf Mar 22, 2018 11:55 PM
signature for material fact sheet.jpg Mar 22, 2018 11:56 PM