New Patient Form

Raleigh Comprehensive and Cosmetic Dentistry understands that our patients want to have their first dental visit with us to be as smooth as possible. To help facilitate this process, we have provided our patient forms online for you to download and complete before your visit. This saves you the effort of filling out the form after you get to the office. So that we can provide you with the best possible care and to prepare for your dental visit with us, we ask that you complete the needed information on the forms and sign them before bringing them to your first appointment.  The completion of this information will assist us in making your dental visit as safe, relaxing and comfortable as possible. We are excited to have you as a patient and we look forward to meeting your dental needs.

Please note: these items require the Adobe Acrobat PDF Reader, which can be downloaded from the Adobe web site.

New Patient Registration Form
HIPAA Forms

Contact Us

Phone: (919) 828-3775
Fax: (919) 828-4937

Glenwood South/
Boylan Avenue
119 North Boylan Avenue
Raleigh, NC 27603

Free parking just steps from our front door.

Member:

TM 2007. Copyright © Raleigh Comprehensive & Cosmetic Dentistry, 2006 – 2020. All rights reserved.
You are hereby advised: this site is fully copyrighted, trademarked, and continuously monitored. All rights to copyrighted and trademarked materials are specifically reserved. Any and all acts of plagiarism in part or whole, will be pursued, prosecuted, and remedied to the fullest extent of the law both domestically and internationally.

Visit Us On TwitterVisit Us On FacebookVisit Us On Youtube