(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] (Coming Soon)

Medical History [PDF] (Coming Soon)

Patient Consent [PDF] (Coming Soon)

Financial Policy [PDF] (Coming Soon)

 

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.