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Patient Forms

We have a patient registration form available for print here, but our office also provides a more streamlined new-patient process to start your smile journey with even more ease and convenience!

If you are interested in scheduling an appointment, please contact the office at (301) 515-8500 and our scheduling coordinator will gladly send you a link to our online new-patient forms.

How to Fill Out Online Forms

To fill out your online digital forms, simply follow the link included in our welcome email. Your login will be the patient’s first and last name and your password will be the patient’s eight digit date of birth. Your new patient forms will be available under the “questionnaire” tab.

We highly recommend you use a mobile device to fill out the questionnaire. If you need to use a computer to fill out the forms, be sure to use an Internet browser other than Google Chrome to access the forms.

Make sure you answer all questions on the online forms as you will not be able to submit an incomplete form. If a question is required, but does not apply to you simply answer “N/A.”

If you need to come back to the forms or need to pause your progress, be sure to select “save” at the bottom of the forms. You can always pick up where you left off as long as you save your progress.

Once you’ve completed the online forms, be sure to click on the signature box at the bottom of the form to add your signature (the box will have a squiggly signature picture). You can sign your work digitally if you fill out the forms on your phone or sign in-office if you use a computer. To finish everything, just press “submit” and our office will receive your responses shortly thereafter.

Our office strives to cut down on time-consuming and repetitive paperwork, so filling out the forms at least twenty-four hours prior to your appointment is highly recommended and greatly appreciated. We can’t wait to start your smile journey!

(301) 515-8500
20680 Seneca Meadows Pkwy #207
Germantown, MD 20876
map & directions
Mon10:00am to 7:00pm Tue8:30am to 6:00pm Wed9:00am to 5:00pm Thu8:30am to 6:00pm