Patient Registration

a patient history formNew patient? The following forms are mandatory for all new patients. To expedite your visit, please print these forms, fill them out, and bring them with you to your first visit.

Medical History Form

Registration Form

Your Teeth Deserve Comprehensive Care

Dr. Burns and his staff are qualified to handle all aspects of your care, so you are always surrounded by people that you trust. Contact us today!

Call us: 540-740-8937