New Patient Forms

If you are a new patient to our office, we will need you to fill out a medical history form and a patient registration form when you arrive. If you would like to save time at the office, please feel free to fill out the forms using the buttons below. Thank you!

New Patient Registration Forms
Notice of Privacy Practices
Information Release Form
Records Release Form

Contact Us


Lake Wylie Pediatric Dentistry
534 Nautical Drive
Lake Wylie, SC 29710

Phone: 803-619-5155
Email Us!

Hours


Monday - Thursday
8:00am - 5:00pm

Summer Hours:
7:30am - 2:30pm