Patient Forms, Map and Directions to Glenn Dale Office
First Visit
When you arrive for your first visit, please be prepared to complete all insurance and health information forms
that will allow us to begin your dental treatment. We will ask you to fill out several forms that will get you
acquainted with our office.
Your initial exam will last approximately one hour. Oral hygiene instructions will be provided along with
suggestions to help you care for your teeth. In most cases, we will also clean your teeth on this visit and
provide an evaluation that will outline your existing dental problems and proposed treatment.
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession, and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms
Please print and fill out these forms so we can expedite your first visit:
- Appointment Policy
- Assignments of Benefits Agreement
- E-Mail Consent
- HIPAA Form
- Medical History Exam
- Patient Registration Form
- Payment Policy
In order to view or print these forms, you will need Adobe Acrobat Reader installed.
Click here to download it.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to
provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling.
Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our
staff
page and familiarize yourself with the doctors. We look forward to your first visit.