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Dental Emergency
770.955.0550
200 Galleria Parkway, SE
Suite 1830
Atlanta, Georgia 30339 Secure Online Payments

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Patient Forms

For your convenience we provide our patients with a safe, secure online form through Dentforms.com. You can save time in our office by filling out this form prior to your appointment. Please remember to bring your dental insurance information and your driver‘s license to your first appointment.

Please click the appropriate link to fill out our online patient form:

New Patient Registration

Medical History Update for Current Patients

If you prefer we also provide our patient forms as PDF files. You can save time in our office by printing these and filling them out prior to your appointment. Please do not forget to bring your completed forms, your dental insurance information and your driver‘s license to your first appointment.

All of our forms are PDF documents which require Adobe Reader. If you are having difficulty downloading, please click below to install the correct software.

Get Adobe Reader