NEW PATIENT FORMS
Option 1: Please follow the link to the new patient forms and fill out your information online.
Option 2: Print and Bring.
Before your first visit, please take couple of minutes to fill out the following forms for all our new patients. You will need Adobe PDF reader to open the file. Please print out and fill the documents accordingly prior to your appointment and then bring them along with you, including our financial policy, HIPAA form, and new patient information sheet.
Also, your insurance card is also necessary to have at your first appointment. Once again we are excited to meet you, and your teeth, for the first time.
Don't forget to bring with you on your 1st Appointment:
1.) Bring New Patient Packet- financial policy, HIPAA form, new patient information sheet.
2.) Bring insurance card.
3.) Bring your driver's license or any other official photo ID.
4.) Arrive 5-10 minutes early so we can get you settled in.
Monday 8:00 am - 5:00 pm
Tuesday 9:00 am - 6:00 pm
Wednesday 8:00 am - 5:00 pm
Thursday 9:00 am - 6:00 pm
Friday 8:00 am - 5:00 pm
Saturday 9:00 am - 3:00 pm
Address: 6211 Executive Blvd
Rockville, MD 20852
Telephone: (301) 468-9001
Fax: (301) 468-9003
E-mail: [email protected]