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FORMS

Dental Clinic - General

Dental Department: New Patient
Information (with call-in dates)

Dental Release of Records form
(print , complete and bring to your
scheduled appointment.)

Dental Release of Records form
(print , complete and bring to your
scheduled appointment.)

Eligibility form - English

Eligibility form - Spanish

Volunteer - Community

Volunteer - Professional

Location and Hours

On-Line & Other Giving

Mission and Community Impact

Patient Services

Financial, Reports, and Statistics

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Filling in the blanks

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San Jose Clinic is a non-profit, 501(c)(3) organization

A United Way Agency

A ministry of the Archdiocese of Galveston-Houston