(803) 532-3331          info@drwallsfamilydentistry.com

       

 

When confirming your appointment, we may ask you to fill out and bring one or more of the following forms:

 Click on the link to download forms.

 

Patient Registration Form [PDF]

Medical History [PDF]

Patient Consent [PDF]

Financial Policy [PDF]

 

Patient Privacy Statement


This form, Notice of Privacy Practices, presents the information that federal law requires us to give our patients regarding our privacy practices. If you would like a copy of our privacy practices, then please contact our office via our Contact Form and we will email one to you. If you prefer a form by US Mail, then put your mailing address in the comments box.

 


Please note: reading and printing PDF forms requires Adobe® Acrobat Reader®Click here to download.