Patient Forms

We know that your time is very valuable to you. In order to allow for the fastest processing during your initial visit to our office we request that you take the time to fill out these forms in the comfort of your own home.

Please fill out our New Patient Information Form, save to your desktop, then email to info@raleighncdentistry.com or print out the form and bring the form into the office on your first visit.

Click here to download the form.

 

Adobe If you don’t have Adobe Reader, click here to download it

 

Policies

Financial Policy

Missed Appointment Policy

Privacy Policy

Authorization for Use and Disclosure of Info

Authorization to Release Health Information

Authorization to Release Health Information to Adams & Cheek

Acknowledgement of Receipt of Notice of Privacy Practices