Newport News (757) 833-7217
Hayes (804) 693-9055
Hampton (757) 723-6565
Give us a call to book an appointment!
Patient Forms
In order to speed up the check-in process, you will receive text message links to these forms to fill out before your appointment. The forms you fill out will vary depending on if you are a new patient or existing patient. If you accidentally delete the text message, you can always visit our website and click the link below to fill out ahead of time.
List of Services
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General ConsentList Item 1
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Missed Appointment-Late Arrival-Cancellation Policy Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Adult Patient Registration Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Child Patient Registration Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Health and Dental History Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Dental Insurance and Financial PolicyList Item 2
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HIPPA Notice of Privacy Practices Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Photography Consent Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
List Item 3 -
Patient Dismissal Policy Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
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Patient Dismissal Appeal Write a description for this list item and include information that will interest site visitors. For example, you may want to describe a team member's experience, what makes a product special, or a unique service that you offer.
List Item 4