Patient Forms


To assist us with your care, and to help make your visit more efficient, please print and complete the following forms, then bring them with you to your appointment.

New Patient Forms – Adult

New Patient Forms – Child

Patient Login

HIPAA – Privacy Policy

Schedule Your Appointment

After you’ve filled out our convenient, online patient forms, schedule your appointment by calling Dr. Cornelius’ office in Keller, TX, at 817-431-4200. We proudly the serve the residents of Keller, Roanoke, Trophy Club, Westlake, Southlake, North Richland Hills, and all surrounding communities.


Ask The Doctor

Be sure to visit our FAQ page to find frequently asked questions and answers about dental health, treatments and procedures.