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Is This Your First Appointment at Chesapeake Smiles?

We are happy you have selected Chesapeake Smiles for your dental care, and we will make sure that your first appointment is easy and comfortable.

For your convenience we have made available all the necessary forms that needs to be filled up and signed before your appointment.  You can download these forms fill them up and fax them to us prior to your appointment.

 

Forms Download:

Patient Registration Form Download Medical History Form Download
Dental History Form Download Notice of Privacy Practices Download

HIPAA Form Download

Treatment Consent Form Download Cancellation Policy Form Download