New Patients

Please download the forms below and bring them with you to your appointment. All forms will need to be filled out in it's entirety. Please remember to bring your insurance card if applicable.

*  MUST Arrive 20 minutes PRIOR to your appointment.

Notice of Practice Policy **

Changing Dentists

For CURRENT patients that are needing to change dentists please print this form and fill out in its entirety and you may fax to (704) 509-4318 or email to

Minor Consent Form

Minor Consent Form.pdf

These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo above to download.

2770 East W.T. Harris Blvd., Suite 102, Charlotte, NC 28213   P : (704) 509-4513   F : (704) 509-4318

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