Permission slip for treatments for children, students, that are dropped off or drive themselves to our office without a legal guardian. If you need cannot be with your child during their dental visit, please fill out the Guardian Permission form and send it with them.
Amalgam Silver Fillings:
For more information regarding amalgam fillings, click here
Blue Cross Federal Plan Participants:
Authorization and Consent To Send Unencrypted Patient Information by Email and Other Electronic Means:
New patients, for your convenience we have placed our new patient forms on this website.
Please print all six forms below. Fill out the registration and history forms. Fill out the new patient survey so we understand your expectations and prior dental experiences. Read and then sign the privacy practices and policies documents. Then bring all six forms with you to your first visit.
If you do not already have Adobe Acrobat PDF Reader installed on your computer,
please go to Adobe and download the Acrobat Reader before opening the documents listed above.
Providing experienced, compassionate dental services for the communities of Eldersburg, Sykesville, Marriottsville, Finksburg, Mount Airy, Taylorsville, Glyndon, Reisterstown, Owings Mills, Deer Park, and surrounding areas.
Conveniently located in South Carroll on Oklahoma Rd. (at the intersection of Rt 26 Liberty Rd, Oklahoma Rd, and Ridge Rd, with the Eldersburg Commons Shopping Center, McDonald's, and Shell Gas Station).
Our driveway is on Oklahoma Road opposite McDonald's and the Oklahoma Road Middle School (click here for driving directions).