ACCESSIBILITY Accessibility
Call: (864)850-9045

PATIENT FORMS

ASK ABOUT OUR IN-OFFICE ZOOM WHITENING AT YOUR APPOINTMENT! 


EXISTING PATIENTS

If this is your first visit after COVID-19 pandemic began, please click the link below and complete forms #1 & #2 on THE DAY OF the appointment. If you have already completed the forms at a previous appointment, you will still need to complete Form #1, as it is required for each visit




NEW PATIENTS 

We look forward to meeting you! We would like to make your transition to our practice as smooth as possible. Please click the link below for a copy of the forms you will need to complete. Please bring these completed forms with you to your first appointment, along with a photo ID and your insurance card (if applicable).  

 ·         New Patient Forms: you may complete these forms online by clicking the link below or you can print, complete the forms, and bring them with you to your appointment.

(Please complete all forms 1-7)

**COVID FORMS #1 & #2 Should be completed the DAY OF APPOINTMENT**


·         ​​Photo Identification: As with any healthcare provider or hospital, we require a copy from any adult patient to verify your identity, protecting you from identity theft or a HIPAA violation. 

·         ​A Dental Insurance Card: if applicable. Please note that in most circumstances, your health insurance and your dental insurance will not be with the same insurance company.

·         Minors (17 years and younger) must be accompanied by an adult/guardian to their first appointment.

·         A 48 hour notice is required to cancel/change an appointment.

Please make every effort to attend your appointment as our schedule books heavily in advance. Thank you for your respect of our time and other patient's time who may be in need of prompt care. See you soon!

If you have existing records at another office and would like to have our office request those on your behalf, please complete the Records Release Form on the Patient Forms page (linked above).

 



 


Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.