Dr. Madhavi Bhoompalli seated chairside, talking with a patient in the treatment room

Patient Forms

Fill these out at home and your first visit starts in the chair, not the waiting room.

What should I fill out before my first visit?

New patients need two forms: the New Patient form and the Medical History form. Both are available in English and Spanish. Print them, fill them in, and bring them with you, along with your insurance card.

You can also complete them at the office before your appointment. Questions about a form? Call 770-814-7600.

  • New Patient FormEnglish

    Patient information, emergency contact, dental insurance, and consent. 3 pages.

    Download PDF

  • New Patient FormSpanish

    Información del paciente, contacto de emergencia, seguro dental y consentimiento. 3 páginas.

    Download PDF

  • Medical HistoryEnglish

    Conditions, allergies, and current medications. 1 page.

    Download PDF

  • Medical HistorySpanish

    Condiciones, alergias y medicamentos actuales. 1 página.

    Download PDF

Ready When
You Are

Book an Appointment

Prefer to talk? Call 770-814-7600 during office hours.