New Patient Forms

We ask that each new patient entering our Cary dental practice complete a registration form that provides us with basic information regarding contact addresses and phone numbers, insurance coverage, and health history. We do ask that you complete this form prior to visiting our Cary dental office, please click on the link below so that you may fill out all of the information on our secured website. In this way we can be better prepared to assist you when you come to your appointment. In order to comply with new federal regulations regarding the Red Flag Rules, we will ask for photo identification (i.e. driver’s license) at your first visit.  This will assist in the prevention of identity theft.  

Should you not be able to fill out the new patient form online prior to your dental appointment, we ask that you arrive 20 minutes earlier.  This will allow time for you to be able to complete the necessary forms without interfering with your scheduled appointment time.  The new patient exam is your most important appointment.  It is when we develop a baseline of your dental health and we need all of the time to concentrate on giving you the best care possible.

Click here to submit the new patient information to us online

The above file is a secured file that you may fill out online.

Below you will also find links to “Notice of Privacy Practices” for HIPAA compliance, “What is HIPAA?” “What to Expect During Your Initial Evaluation,” and “Our Office Philosophy Regarding The Practice of Dentistry.”

You can choose to either read the files online or print them to read at your leisure. You do not need to bring them to your NP exam.  However, we have to provide the “Notice of Privacy Practices” to you by law so that we can comply with HIPAA requirements. 

We suggest you read “Our Office Philosophy Regarding The Practice of Dentistry,” at your leisure.

Click below to view or print:

 “Notice of Privacy Practices”

 “What is HIPAA?” 

 “What to Expect During Your Initial Evaluation”