Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

New Patient Forms 


 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
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We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Hecox Dentistry
Ashton W. Hecox, D.D.S. & Mike W. Hecox, D.D.S.
Dentistry you, your family, and friends deserve

If you are looking for Family Dentistry, or Cosmetic Dentistry, Cozad Dental Practice, Hecox Dentistry offers dental cleanings, teeth whitening, dental restorations, emergency dental care and more. Please come and visit Cozad, NE Hecox Dentistry.

2021

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Our Office

1014 Lake Ave.Gothenburg, NE 69138Get Directions(308) 537-5252

2021

Site Map


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