1550-A Janmar Rd. ~ Snellville, GA 30078 ~ 770-978-7990
New patient registration documents available below. Please download appropriate document, bring completed form with you to your first appointment.
Notice of Privacy Practices is available for you to download and view but is not necessary to print out unless you want a hard copy for your record.
Medical Records Release is also available, if you have prior records and would like to transfer them to our office please download, complete and have records sent to our office from previous provider. Please call with any questions regarding these documents.
Adult New Patient Registration Form
Child New Patient Registration Form
Notice of Privacy Practices
Print Appropriate Form
(Bring Completed To Your Appointment)
Medical Records Release Form
Release form is available for patients to request their dental records as needed. Please fill out the form with indication of how the records should be made available and you may present this to the office during regular business hours.
Please call with questions or concerns regarding records request or inquires.