Call: (757) 426-6151

Patient Forms

Thank you for your interest in our dental practice.  We are always happy to welcome a new smile.

You will find some forms and information which can make your first visit with us more convenient.  Please answer the personal and health history information as completely as possible, because it is vital that we have complete and accurate knowledge of our patients in order to give them the very best of care. We also ask you to review and sign the policy information forms and to bring your dental insurance card to your appointment.

We feel it is our obligation to all our patients to treat them just as if they were members of our own families.  The skill and expertise we have gained over many years will be focused on helping you to achieve and maintain optimal dental health, so you can avoid potentially costly and painful dental problems.  We don’t want those kinds of problems for our families, and we don’t want them for you or your family either.

We look forward to meeting you in the very near future. 

 Please print and fill out either the information forms for an adult or a child and the Notice of Privacy Practices (HIPAA) and bring them with you to your appointment.

New Patient Information Forms
New Patient Information Forms (CHILD)
Financial Policy
Notice of Privacy Practices

1557 notice and grievance policy.docx

 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.


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Office Location

  • Virginia Beach
  • 1767 Princess Anne Road
  • Virginia Beach, Virginia
  • 23456
  • Map & Directions
  • Call: (757) 426-6151