Dentists Charlotte, NC | My Dentists

411 Billingsley Rd #102 Charlotte, NC, 28211 – (704) 375-8577
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Below you will find several informational forms to fill out prior to your arrival at our office for your appointment. You may complete the first form online or complete the last 4 forms.  You may fax these forms prior to your arrival to 704-331-9987 but please also bring them with you on your appointment day.

 The forms include:


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If you should have any questions regarding your appointment or insurance coverage, please contact our office at 704-375-8577.

Along with the enclosed forms, please bring the following to your upcoming appointment:

  • Insurance Card: (If you do not have a dental insurance card you will need to bring the following information with you: Ins name, address, phone #, ID# and group #)
  • Co-Pay or Deductible: All major credit cards and Care Credit are accepted.

Completing these forms with their required signatures and having your insurance card/information can dramatically decrease the time required for check-in. In the event you need to reschedule your appointment, we ask that a minimum of 24 hours notice is given. We appreciate your assistance and we look forward to meeting you soon at your visit.



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