Attention New Patients:
Please complete the following forms: Registration Form, Dental & Medical History Form, HIPAA Acknowledgment Form, Authorization for Release of Information, and Scheduling & Financial Policy. Links to the forms are listed below.
Bring the completed forms to your appointment, or fax it to us at 919-469-2034, or email it to us at firstname.lastname@example.org. (Be sure to print the forms before trying to fax or email.)
If you are unable to complete your forms prior to your appointment, please plan to arrive 10 to 15 minutes early.
Dental & Medical History