New Patient Form

We understand that your first visit to the dentist can feel overwhelming and we try to accommodate all new patients with a comfortable and organized facility.

Our staff has taken the steps to prepare you for the first appointment by providing a full spectrum of the services we offer and the option to complete our new patient form prior to your visit. Our goal is to cover everything you need with a full and efficient assessment, but without waiting to see the doctor.

Step 1 of 2

  • Patient Information

  • Spouse, Guarantor, or Responsible Party Information-Information must be completed if patient is a minor

Other Forms

Fax us your printed and completed forms or you may bring them during your visit.

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Member of the Tennessee Dental Association
academy of general dentistry member
Care Credit Dental Financing