Download Forms

Download, print, and fill out our forms beforehand. Be prepared and your kid's dental visit will be smooth and easy.


Shorten Your Wait Time!

Let's focus more on your child's oral health instead of meaningless waiting time. That is why we offer these downloadable PDF forms. for your convenience the forms that need to be reviewed and completed are listed below. Just click on the links below and you can download the forms to your computer, print them and fill them out on your time!

Please bring the completed forms with you when you visit Smile Factory Pediatric Dentistry.

Download Forms

Form Name
Medical History Download
Conscious Oral Sedation Treatment Post Operative Instructions Download
Informed Consent for Composite Tooth Colored Fillings Download
Informed Consent for Nitrous Oxide Sedation Download
Informed Consent for Tooth Removal Extraction Download
Dr. Alejandro Esquivel - Eagle Pass, TX

“ Bring them before the pain begins. ”

— Dr. Alejandro Esquivel

Smile Factory Pediatric Dentistry

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Boys Girls Dentistry - Eagle Pass, TX 78852

Specialized Pediatric Dentist

Dr. Alejandro Esquivel earned his DDS from the University of Monterrey, Mexico. He then attended the University of Puerto Rico and received his specialty degree in Pediatric Dentistry. After a one year Fellowship at the Children's Hospital of Colorado, he decided to offer his care to the children of Eagle Pass, TX and surrounding areas.
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Medical Insurance Accepted

Smile Factory accepts Denta Quest, Group & Pension, Health Smart, MCNA Dental, Medicaid, Metlife, and Texas Medicaid Healthcare Partnership! Not sure if you will be covered?
Please book an appointment or give us a call at (830)757-9700. Walk-ins are always welcome.

  • Denta Quest


  • Group & Pension


  • Health Smart


  • MCNA Dental


Smile Factory Pediatric Dentistry - Medical Insurance Accepted
  • Medicaid


  • Metlife


  • TMHP


  • Healthy Smiles