Skip to main content

New Patient Forms

Options for submitting New Patient Forms

1. New Patients may print forms to fill out prior to their appointment. Click the link below to print out our forms.

Fill out form and send to our office. You may:

  • Drop them off anytime before your appointment

  • Mail forms:
    West GA Family Dentistry, 8590 Bowden Str., Douglasville, GA 30134

  • Fax Forms:
    770 949-0707

  • Bring them to your appointment

Form must be received at least 72 hours prior to your appointment in order to verify your insurance benefits. Once benefits are verified, you may only be required to pay your deductible and portion of your charges at the date of service.

If your insurance has not been verified at the date of your appointment, charges are to be paid in full and we will be happy to submit your insurance to you for reimbursement.

New patients may fill out forms at our office 15 minutes prior to their dental appointment.

When using this option, your charges are to be paid in full at your first appointment.
Any other financial arrangements must be made in advance.