New Patient Forms
We offer online and paper form options. Pick Your Preference.
Step 1
If you have not yet scheduled an appointment, call us at (980) 222-7501 to schedule your first appointment or request an appointment using the link below.
Request AppointmentStep 2
Access and complete our new patient forms electronically—for adults and/or children—using the link below.
Step 3
If you are unable to get directions from our contact page, you may call our office at (980) 222-7501 to get more detailed directions.
Contact and Location InformationNew Patient Resources
If you prefer paper copies of all forms, please select each form below, download, print and either bring with you to the office or email us at [email protected].
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Notice of Privacy Practices
Download PDF -
Patient Registration
Download PDF -
HIPPA, Financial and Appointment Policy
Download PDF -
Medical History
Download PDF
Insurance and Financing
We believe quality dental care should be affordable and accessible to everyone. Because oral health is so important, we do everything we can to remove financial barriers and help the greatest number of patients possible. We accept most insurance providers and third-party payment alternatives for those without insurance.
Insurance and Payment InformationQuestions?
Whatever your questions are please don't hesitate to reach out to our office, we are more than happy to assist.
Contact Us With Questions