Patient Forms

Patient Forms for New Patients

We encourage you to complete your registration prior to your visit to our Marietta dentists if possible.

Please print, fill out and bring the following forms with you to cut down on your wait time. If you are new to the practice, it is extremely helpful if you are able to have your previous dental office email or send any prior dental X-rays or pertinent information to us that we may need.

These documents are in Adobe PDF format. If you’re unable to read PDF files, please download free Adobe Acrobat Reader here.

Patients Who are Minors:

Attendance by a parent or an arrangement with consent must be made in advance of the appointment. A parent cannot simply drop his or her child off at our Cobb dental office and expect care to be given. If you have a teenager who drives and will arrive separately to our office, please let us know ahead of time.


We expect you to take care of your balances at the time of your appointment. Our specialized software estimates what your insurance covers. We can work with you and contact your insurance company directly to collect payment from your insurance company.

Set up an appointment today for East Cobb dentistry services!

Your teeth and gums are important parts of your body. At East Cobb Family Dentistry, our team of Marietta dentists shares your desire to achieve and keep beautiful teeth and gums — and an overall smile — for your lifetime.

Dentists Proudly Serving
Marietta Since 1996

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Call Us Today at: (770) 913-6800

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