New Patients and Online Forms

Welcome to our Practice!

We are delighted to welcome you to our practice and are pleased that you chose us to serve your dental needs.  To facilitate being seen just as soon as possible at the time of your appointment, we would appreciate it if you would complete the following at least 2 days prior to your dental appointment. 


1.      Below are your Online New Patient Forms, Payment Policy, and Cancellation Policy.

2.      Please have your previous dental office email all x-rays that have been taken within the last 12 months to:  

If you are unable to make the appointment you have scheduled with us, please notify us at least 48 hours in advance. We would be glad to reschedule the appointment at a more convenient time, if necessary.  In the meantime, we look forward to meeting you and serving you and your needs.

New Patient (Adult)

New Patient (Child)

Thanks again for choosing our dental practice.

Dr. Mark Simmons & Staff

Mark A. Simmons, D.D.S.
13549 US Highway 87 West La Vernia, TX 78121
Phone: (830) 779-6511 URL of Map