Patient Forms

We care about your smile! Let us handle all of your dental needs in the Durham, Raleigh, and surrounding NC areas.

Whitening, Hygenist, Pediatric, Implants, Affordable, Medicaid, Nearby , Emergency, Weekend, Specialist, dentist, durham, tooth ache,

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Patient Forms

A little bit of time now will save you a lot later.

Print and complete the appropriate forms below before you come in for your visit.

+1 919-973-0178

601 Fayetteville St. Suite 100

Monday & Thursday 10am-5pm
Tuesday & Wednesday 12pm-7pm
Third Saturday Monthly 9am-2pm
Friday 10am-4pm

Patient Forms

A little bit of time now will save you a lot later.

Office Rules & Policies

New Patient Registration

HIPPA Consent Form

Trained and trusted to make you smile

Where people come first

+1 919-973-0178

601 Fayetteville St. Suite 100

Monday & Thursday 10am-5pmTuesday & Wednesday 12pm-7pmThird Saturday Monthly 9am-2pm Friday 10am-4pm

Patient Forms

A little bit of time now will save you a lot later.

Office Rules & Policies

New Patient Registration

HIPPA Consent Form

Trained and trusted to make you smile

Where people come first

Monday & Thursday 10am-5pm
Tuesday & Wednesday 12pm-7pm
Third Saturday Monthly 9am-2pm
Friday 10am-4pm