Patient Center - COLUMBIA, MD

You’ll Love How We Treat You Here

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New Periodontic Patients

Please assist us at the time of your initial visit to the office by providing the following information:

Please Note: All patients under 18 must be accompanied by a parent or guardian at the consultation appointment.

 

Our entire team looks forward to helping you achieve your dream smile with affordable treatment tailored to your needs.

Please notify the office if you have a medical condition or concern prior to surgery (e.g. artificial heart valves or joints, heart murmurs requiring pre-medication, severe diabetes, or hypertension). We will complete an in-depth medical and dental health history and a thorough examination to measure for bone loss, loose teeth, bite, oral cancer screening, TMJ, and other signs of periodontal disease.

Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

You Are Welcome Here.

Schedule your new patient appointment today.

By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message and data rates may apply. Reply STOP to opt out of further messaging.

I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.

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