Coastal Orthodontics | Corpus Christi Orthodontist & Braces

Dr. Daniel Torres
361 . 993 . 2288

Welcome to Coastal Orthodontics

New Patient Forms

For your convenience our new patient forms are available for you to download and complete prior to your consultation appointment. Or you can e-mail completed forms to: Corpchrs@orthodon.com.

English

New Patient Form

Notice of Privacy Practices

 

Acknowledgement of Receipt of Notices

 

Authorization to use or Disclose Protected Health Information

 

Orthodontic Office Policies

 

Letter of Information and Consent Agreement

Spanish

Notice of Privacy Practices

 

Acknowledgement of Receipt of Notice

 

Authorization to use or Disclose Protected Health Information

We maintain strict standards and procedures to prevent unauthorized access to your personal information and ensure correct use of information. While we strive to protect your personal information, we cannot ensure the security of any information that you transmit to us over the internet and you do so at your own risk. However, once we receive your transmission, we take reasonable steps to ensure that your information is secure on our systems.

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