Forms

Please print and fill out each one of the listed forms and bring it to your initial appointment. Each fillable form can be completed online and printed to bring to the initial appointment.

New Patient Forms

HIPAA Forms

Patient Registration Notice of Privacy Practice
Financial Policies Acknowledgement of Privacy Practices
Medical History Verbal Communication Release
General Consent Form

Adobe Acrobat Reader

Contact Us

101-A Chadwick Square Court
Hendersonville, NC 28739

Listen to what our patients have to say!

Today I had a 2 1/2 hour appointment with Dr. Pete Richards to repair a crown which had come off. In the process he cleaned off the remainder of the old tooth, performed a root canal, built up the old tooth and created a new crown, which was put in place. He along with his staff was highly professional, friendly and did an outstanding job. Frank Sacho, 1/21/2015

Read Patient Testimonials >