Request Dental Records

To obtain your child’s dental records and x-rays for continued dental care, please complete the form below.

This request must be made by the child’s custodial parent or legal guardian. To ensure privacy and compliance with regulations, dental records can only be released directly to the custodial parent, legal guardian, or a licensed dental provider for ongoing treatment purposes.



If you need assistance or have any questions regarding the request process, please contact our office at (806) 292-9115.