Please be aware that this is not a secure email network under HIPAA guidelines. Do not submit any personal or private information unless you are authorized and have voluntarily consented to do so. We are not liable for any HIPAA violations. Understand that if you email us, you are agreeing to the use of an unsecured method and understand that all replies will be sent in the same fashion, which you are hereby authorizing.

By checking this box and submitting this form, you hereby agree to hold Padre Island Family Dentistry, including its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties.
By checking this box and submitting this form, you also agree to receive email and SMS communication from Padre Island Family Dentistry, including its doctors and affiliates. This may include appointment reminders, practice updates, review requests, and other information. Standard messaging rates may apply. You may reply STOP to any SMS message to opt out of SMS communications anytime.