PATIENT FORMS

Welcome to our Oakton-Vienna dental practice, and thank you for choosing our office for your dental care. Our goals are to provide outstanding dentistry through education, prevention and high standards.

Most of our patients come by referral. When one recommends us to a friend or family member, we consider it a great compliment. We value you and are honored to have you, your family and friends as patients in our practice.

Our desire is to develop a relationship with you based on trust and mutual responsibility. Please know that your needs come first in our practice. Our commitment to you is to provide you with the best treatment that dentistry has to offer, and to restore and maintain both function and beauty for a lifetime.

Depending on your current dental condition, an appointment will be scheduled to discuss the type of treatment plan best suited to your needs or an appointment with our hygienist for a routine cleaning and exam. At this visit, future appointments will be determined, estimated fees discussed and financial arrangements completed. The goal of this appointment is to determine a custom treatment plan that will be a road map to optimum oral health.

Here, on our website, you will find our patient forms. Please complete these  forms and return to us either by scanning and resend to smiles@oaktonfamilydentistry.com or fax to 703-281-6208 or bring them with you to your appointment  so that we have the information we need to serve you better.

PATIENT REGISTRATION FORM

MEDICAL HISTORY

SIGNATURE FORM FOR FINANCIAL POLICY & NOTICE OF PRIVACY PRACTICES

FINANCIAL POLICY & NOTICE OR PRIVACY PRACTICES – Read Only, please complete Signature Form above.

NOTICE OF PRIVACY PRACTICES-Read Only, please complete Signature Form above.

We thank you in advance for honoring all the appointments you may schedule with our office because this time has been reserved especially to meet your needs. Should you need to cancel your appointment we require 48 hours notification. We look forward to seeing you soon at Oakton Family Dentistry!