BALLARD DENTAL CARE Dr. Jeffery Cole
BALLARD DENTAL CAREDr. Jeffery Cole

new patient paperwork

New patient? Please take a moment to print and fill out the following forms and plan to bring with you to your first visit. You can also email them to us at ballarddentalcare@gmail.com If you are not able to complete your forms at home, plan to arrive 15 minutes early to complete them prior to your scheduled appointment time.

Patient Registration.pdf
Adobe Acrobat document [320.1 KB]
Financial Privacy Policy.pdf
Adobe Acrobat document [1.8 MB]
Records Release Form.pdf
Adobe Acrobat document [257.0 KB]

Your smile is an investment for a lifetime!

 

The greatest compliment our patients can give is the referral of their friends and loved ones.

 

Refer a friend or family member to us and be sure they mention your name so that we can personally thank you. We'll also send you a $25 gift card to show our appreciation.

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