Patient Resources

One of our biggest priorities at Hebron Smiles is to make dentistry convenient for you. We have made our necessary forms accessible for you to download and print on your home computer so you do not have to spend unnecessary time in our office filling out paperwork.

If you have any questions about your patient forms, please do not hesitate to contact us.

Patient Forms

New Patient Registration Form
Acknowledgement of Receipt Form
APPENDIX I - Acknowledgment of Receipt of Notice of Privacy Practices and HIPAA Communication Consent
Office Policy Form
Photography Release Form
HIPAA Notice of Privacy Practice
Orthodontic Consent Form

Payment Options

Hebron Smiles is in-network with multiple dental insurance companies. We file claims as a convenience for our clients.

We accept cash, check and credit cards.

Herbon Smiles, Carecredit logo

Our practice offers Care Credit patient financing options and payment plans.

Herbon Smiles, Carecredit Apply now card

Our practice is pleased to offer Springstone Patient FinancingSM. A variety of flexible plans provides low monthly payments with no money down and no payment for 3-7 weeks. You can calculate monthly payment options or you can place an application. For more information on this attractive option, just ask our team or visit springstoneplan.com.

Hebron Smiles, Special Offer
Hebron Smiles, Whitening For Life at Hebron Smiles
Hebron Smiles, GLO is the perfect gift for the Holiday at Hebron Smiles
Hebron Smiles, Exam with Free x-ray
Hebron Smiles, Invisalign Logo Hebron Smiles, Carecredit Logo Hebron Smiles, Lending Club Logo

Accreditation - Hebron Smiles

Hebron Smiles, American Dental Association Logo Hebron Smiles, Modern Study Club Logo Hebron Smiles, Dr Adnan Saleem, DMD The Dallas County Dental Society Hebron Smiles, Dr Adnan Saleem, DMD The North Texas Dental Society Logo Hebron Smiles, Dr Adnan Saleem, DMD The Texas Dental Association Logo
Dr Adnan Saleem, DMD Appointment Request