Patient Forms

Save Time Before Your Visit

Download and complete your dental registration forms before your first appointment. Bringing completed forms with you helps our team check you in faster and keeps your visit moving smoothly.

Use the general new patient forms for registration and medical history, then review the HIPAA and privacy forms that apply to your visit.

New Patient Forms Forms By Location

Before You Arrive

Please print and complete the forms that apply to your appointment. If you are unsure which forms you need, contact the Friendly Dental Group office you plan to visit.

Registration

New Patient Forms

Download the welcome, privacy, and medical-history forms for new patients.

Welcome to Practice Notice of Privacy Practices New Patient Medical History Form Aviso de Practicas de Privacidad Formulario de Historia Clinica de Nuevo Paciente Carta de Bienvenida

Privacy & Records

HIPAA Forms

Use these forms for records requests, disclosure accounting, alternative communications, and privacy acknowledgements.

Release of Medical Records Accounting of Disclosures Record Release to Patient Alternative Communications Web & Social Media Release Form Notice of Privacy Practices Privacy Practice Consent Release Form Aviso de Practicas de Privacidad Formulario de autorizacion de consentimiento de practica de privacidad

Location-Specific HIPAA Forms

HIPAA Forms By Location

Choose your Friendly Dental Group office to download location-specific privacy-practice notices in English or Spanish.

Ballantyne

English Notice Spanish Notice

Carmel Commons

English Notice Spanish Notice

Concord

English Notice Spanish Notice

Concord Mills

English Notice Spanish Notice

Creekside

English Notice Spanish Notice

Crown Point

English Notice Spanish Notice

Durham

English Notice Spanish Notice

East Charlotte

English Notice Spanish Notice

Galleria

English Notice Spanish Notice

Gaston Mall

English Notice Spanish Notice

Gastonia

English Notice Spanish Notice

Harrisburg

English Notice Spanish Notice

Indian Land

English Notice Spanish Notice

Indian Trail

English Notice Spanish Notice

Kannapolis

English Notice Spanish Notice

Monroe

English Notice Spanish Notice

Mooresville

English Notice Spanish Notice

Northlake

English Notice Spanish Notice

Rivergate

English Notice Spanish Notice

Rock Hill

English Notice Spanish Notice

Siskey

English Notice Spanish Notice

Southpark

English Notice Spanish Notice

University

English Notice Spanish Notice

Waverly

English Notice Spanish Notice

Whitehall

English Notice Spanish Notice

Winston Salem

English Notice Spanish Notice

Woodlawn

English Notice Spanish Notice

Need Help?

Bring Completed Forms To Your Visit

Contact your office if you have questions about which forms to complete before your appointment.

Schedule An Appointment Find A Location