Below are the new patients forms we require at Dedicated Smiles. You may print a copy to bring to your visit, or you may submit them electronically here. Either way you prefer, we want to make your registration with our office as simple and convenient as possible. If you have questions or would like to arrange a visit with our dentist, please give us a call. We look forward to providing you with quality dentistry in Woodbridge, Virginia.
New Patient Registration Form (required)
Office and Financial Policy Form (required)
Acknowledgement of Privacy Practices (required)
Treatment of a Minor Form (required if needed)
Notice of Privacy Practices (required)
Online Forms
Download Forms
New Patient Registration Form
Office and Financial Policy Form
Acknowledgement of Privacy Practices
Treatment of a Minor Form
Notice of Privacy Practices
General Dentistry Informed Consent Form
