7502 Iron Bar Lane

Gainesville, VA 20155

Patient Resources

Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.

Cancellation Policy: We require a 48 hour notice for any changes to your reserved time in order for you to avoid a broken appointment fee ($50 per hr).

New Patient Forms Packet

New Patient Forms Packet

All you need to print and fill out in one simple file!

Notice of Privacy Practices

Notice of Privacy Practices

You do not have to print, it's just for you to review.

Record Transfer Authorization

Record Transfer Authorization

Print only If you would like your dental records to be transferred.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.