Patient Forms

HomePatient Forms

For faster service, please complete either an adult or child New Patient Registration form prior to your appointment. Thank you!

New Patient Registration (Adult)
New Patient Registration (Child)

Our pledge is to provide your family with beautiful, healthy smiles for a lifetime.

Call (336) 372-8299 now or click below to schedule your next appointment.

Make an Appointment

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Install social plugin that has it's own SHORTCODE and add it to Theme Options - Socials - 'Login via Social network' field. We recommend: Wordpress Social Login