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Dental Patient Form Downloads


Save time and eliminate the hassles of filling out dental registration forms when you visit us. For your convenience, simply download and print the forms below.

Just complete before you visit, and remember the forms when you visit us for the first time

New Patient Forms

1. Welcome to Practice
2. Notice of Privacy Practices
3. New Patient Medical History Form
4. Aviso de Practicas de Privacidad
5. Formulario de Historia Clínica de Nuevo Paciente
6. Carta de Bienvenida

HIPPS Forms

1. Release of Medical Records
2. Accounting of Disclosures
3. Record Release to Patient
4. Alternative Communications
5. Web & Social Media Release Form
6. Notice of Privacy Practices
7. Privacy Practice Consent Release Form
8. Aviso de Prácticas de Privacidad
9. Formulario de autorización de consentimiento de práctica de privacidad

HIPPA Forms by Location

Ballantyne

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Carmel Commons

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Concord

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Concord Mills

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Durham

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Galleria

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Gaston Mall

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Gastonia

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Indian Land

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Indian Trail

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Kannapolis

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Mooresville

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Rivergate

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Rock Hill

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Siskey

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Southpark

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

University

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Whitehall

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Winston Salem

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad

Woodlawn

1. Notice of Privacy Practices
2. Aviso de Prácticas de Privacidad


About Us

The Friendly Dental Group is one of the largest and fastest-growing dental practices in the Charlotte area and the Carolinas, providing a wide range of dental care services, including; teeth whitening, extractions, braces and Invisalign, dentures, tooth fillings, and many other dental care procedures.

Our dentists and staff members are committed to providing our patients throughout North and South Carolina with high-quality customer service! At Friendly Dental Group, we strive to meet and exceed every patient's needs and expectations.


Questions & Appointments:
1-866-764-5387

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