Patient Forms

 
704-504-8070

 

Please complete forms one and two, print these out and bring them with you to your first visit with us.  Please review form 3, the dental insurance policy.  Form 4 is for patients who are transferring their x-rays.  We look forward to meeting you soon!

1.  New Patient Registration.doc  (Medical History and Registration)

2. Release of Information.doc      (HIPPA form)

3.  Dental Insurance Policy.doc        (Our policy on dental insurances)

4.  Xray Release Form                      (Release form for patients who are transferring)

 

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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 contact form below.

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