We want your experience with us to be as convenient as possible. That is why Tieken Smiles Dentistry provides our patient forms online! We encourage you to fill out your forms before your appointment with our dentists, which will help smoothly transition you into your visit with Dr. Derek Tieken or Dr. Dylan Rutherford when you arrive at our office. Call 281-334-4944 for more details about our dental care in League City, Texas.

Financial Resposiblities:
Patient Information:
Dental Insurance
Medical History
Dental History
Privacy Practices
Consent to Digital Photography
Records Release to Patient
Sleep Assessment

Wondering about our financial options? We accept all forms of payment and work with CareCredit® to provide additional payment options that meet your budget. Call our office today to learn more details.

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