PATIENT FORMS & RESOURCES

Photo of girl in dental chair

Forms

Patient Info and Release Authorization

Consent for Use of Photos

Check In Form

Referring Doctors

Click to download and print a patient referral form.

Helpful Links

American Dental Association
Academy of General Dentistry
Dental Health Online
American Academy of Pediatric Dentistry
West Virginia Dental Association
Translation Services

Charleston Pediatric Dentistry complies with the applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.