Patient Forms

Because we know your time is valuable, we have provided access to our patient paperwork below. If you have any questions, please feel free to call our office at  336-272-6235.

Patient Account Access and New Patient Forms

Click on the links below to register as a new patient, or sign in to view your account information and have access to appointments, electronic payments and more. If you have any questions, please feel free to call our office.

Existing Patient Login
New Patient Registration

Notice of Privacy Practice

Patient Information

We have provided further patient paperwork below. Please download and print the specific consent, instructional and/or informational forms you need below. If you have any questions, please feel free to call our office.

Consent Form – Extraction
Consent Form – Veneers
Consent Form – Crown
Consent Form – Endodontic Therapy
Consent Form – Bisphosphonate Drugs

Instructions – Extraction
Instructions – Bleaching
Instructions – CHX Oral Rinse
Instructions – Disclosing Tablets
Instructions – Gum and Erosion
Instructions – Homecare for Dentures
Instructions – Perio Check Oral Rinse
Instructions – Saltwater Rinse
Instructions – Toothpaste 1.1

Information – Dry Mouth
Information – Medications that Cause Dry Mouth