Patient Forms

We pride ourselves on being a paperless office. Not only does this allows us to be mindful of our environment but also helps us to keep costs low. It also allows us to be more efficient by saving time which we enjoy passing on to you. To help us achieve these goals, below you will find informational forms that we request you complete prior to your appointment.

 

In the event you need to reschedule your appointment, we ask that a minimum of 24 hours notice is given.

Save time by filling out your form online!

With our new online Patient Information Forms, there’s no need to print anything!

 

New Patients

Fill out this form completely, and we will get in touch with you shortly:

get-started-button

 

 

 

Current Patients

If you need to update any information, please fill out this form:

get-started-button

 

 

 

You can still print out the following PDF documents and bring them in at your next visit,
fax them to 704-331-9987, or email them to info@mydentists.org.

Items to bring with you to your appointment:

 

  • Driver’s License or Picture ID
  • Insurance Card
    • If you do not have a dental insurance card, please bring the following: insurance name, address, phone number, ID number, and group number
  • Co-Pay or Deductible
    • All major credit cards are accepted

Documents to review before your appointment:

 

Statement of Privacy Practices

Statement of Financial Policy