New Patients in South Charleston

Prior to first appointments, we at the pediatric dentistry Young Smiles like to have a little information about each patient. You can save time by printing the two forms below and fill them out prior to your first appointment.

  • You can print the form here and bring it with you on the day of your appointment, or You can fill it out in the office the day of your appointment (please arrive 15 minutes early).

New patient pdf for Young Smiles pediatric dentistry in Charleston West Virginia

Patient Registration From

New patient pdf for Young Smiles pediatric dentistry in Charleston West Virginia

Medical History

New patient pdf for Young Smiles pediatric dentistry in Charleston West Virginia

Parental Consent

New patient pdf for Young Smiles pediatric dentistry in Charleston West Virginia

Privacy Policies

New patient pdf for Young Smiles pediatric dentistry in Charleston West Virginia

Broken Appointment Policy