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New Patients Form

New Patients Form

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Online Forms

Fill Out Your Forms Before You Arrive

Once your appointment is confirmed, the fastest and easiest way to get ready for your visit is to complete your paperwork through our secure online patient portal. Filling out your information ahead of time means less waiting in our reception area and more time getting to know your dental team on the day of your appointment. Whether you're bringing yourself or your child in for their first visit, we have a dedicated form ready for you below.

Printable Patient Forms

Prefer Paper? We've Got You Covered

If you encounter any difficulties with our online forms, we have conveniently provided printable patient forms below. Please feel free to download, print, and complete these forms:

Health History Adult

Share your medical background and current health status so our team can provide personalized, safe care.

Download Form

Health History Child

Provide your child's medical history so we can tailor a gentle, age-appropriate treatment plan.

Download Form

New Patient Registration

Register your contact, insurance, and emergency information with our office ahead of your visit.

Download Form

HIPPA Notice of Privacy Practices

Review how your protected health information is used, shared, and safeguarded by our practice.

Download Form

HIPPA Receipt of Privacy Practices

Acknowledge receipt of our privacy practices notice as required by federal law before treatment.

Download Form

HIPAA Authorization to Release Patient Information

Grant permission for our office to share your records with another provider, family member, or insurer.

Download Form

Getting Ready

What to Expect at Your First Visit

We understand that visiting a new dentist can feel like a big step, whether you are moving into the Burtonsville area, switching providers, or bringing your child in for their very first checkup. Our goal is to make that transition as smooth and comfortable as possible, starting long before you walk through our doors. That's why we ask every new patient to complete our forms in advance - it allows us to review your history, understand your goals, and prepare a visit that's tailored specifically to you.

Completing your paperwork online through our secure patient portal typically takes just a few minutes. You'll be asked about your medical history, any current medications, allergies, previous dental work, and insurance details. If you're filling out a form for your child, we'll also ask about their growth, habits, and any concerns you may have noticed, such as thumb-sucking, teeth grinding, or sensitivity. This information helps our clinical team walk into your appointment already informed, so more of your time in the chair can be spent on care rather than paperwork.

We know that not everyone prefers filling out forms on a screen, and that's perfectly fine. Our printable patient forms are designed to be just as thorough and easy to complete by hand. Simply download the form you need, print it at home, fill it out, and bring it with you to your appointment. If you're unable to print at home, you're always welcome to arrive a little earlier and complete the forms in our reception area - just let our front desk team know when you schedule your visit so we can plan accordingly.

On the day of your first visit, please bring a valid photo ID, your insurance card (if applicable), and a list of any current medications you're taking. If you have recent x-rays or records from a previous dentist, feel free to bring those along as well, or let us know and we can help coordinate having them transferred. Arriving a few minutes early gives you time to settle in, meet our front desk team, and finish any last details before your appointment begins.

Your first appointment will typically include a comprehensive oral examination, digital x-rays if needed, a professional cleaning, and a conversation with your dentist about your oral health goals and any concerns you'd like to address. We take the time to explain what we find in clear, straightforward language - no confusing jargon, no pressure. If treatment is recommended, we'll walk you through your options, associated costs, and how your insurance may apply, so you can make an informed decision with confidence.

Our entire team, from the front desk to the treatment chair, is committed to making every new patient feel welcomed and cared for. If you have questions about the forms, your coverage, or what to expect, don't hesitate to give us a call at (301) 421-1002. You can also learn more about our practice on our About page, explore our full range of treatments on our Services page, or review accepted plans on our Insurance page.

Common Questions

Frequently Asked Questions

Do I need to complete forms before my appointment, or can I fill them out in the office?

We strongly encourage completing your forms online before your visit so that your appointment time can be spent focused on your care rather than paperwork. However, if you're unable to complete them ahead of time, you're welcome to arrive a bit earlier and fill them out in our reception area, or download and complete the printable versions at home.

Which form should I use - the Adult Patient Form or the Child Patient Form?

Use the New Adult Patient Form if you are 18 years or older and scheduling your own appointment. If you're bringing a child in for their first visit, please complete the New Child Patient Form instead, as it asks specific questions about growth, development, and pediatric dental habits.

What if I have trouble accessing or submitting the online forms?

If you encounter any difficulties with our online portal, don't worry - we've provided printable versions of all our patient forms on this page. Simply download, print, and complete them at home, then bring the completed forms with you to your appointment.

Why do I need to sign the HIPAA-related forms?

The HIPAA Notice of Privacy Practices, Receipt of Privacy Practices, and Authorization to Release Patient Information forms are required by federal law. They inform you of how your protected health information is handled and, where needed, give us your permission to share your records with other providers, family members, or your insurance carrier.

What should I bring with me to my first appointment?

Please bring a valid photo ID, your dental insurance card if you have one, a list of any current medications, and your completed forms if you filled them out on paper. If you have prior dental x-rays or records, feel free to bring those as well.

How can I ask a question about my forms or insurance before my visit?

Our friendly team is happy to help. Give us a call at (301) 421-1002 and we'll walk you through anything you need, or visit our Insurance page for more details on accepted plans.

Real Results

Our Smile Transformations

See how implants, whitening, and same-day crowns have restored confidence for patients in Burtonsville. Results vary; we will show you what is realistic for your smile during a consultation.

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Smile transformation before Before
Smile transformation after After
Smile transformation before Before
Smile transformation after After