New Patients:
Existing Patients:

Online Registration; Dental & Medical Forms

For your convenience, Richmond Family Dentistry (RFD) has supplied forms that can be filled online. Click on the links below, complete the required online forms and click the submit button at the end of the forms. They’ll be ready for you when you make your first visit! The team looks forward to greeting you!

Patients are required to fill out these TWO online forms prior to their visit and arrival to the office:
Patients should review the following RFD policies:
Patients are requested to confirm that they read the financial and privacy policy forms when they fill out online registration and medical forms.

New Patient’s Dental Records

New patients can have their dental records (PAs, CBCT scans, X-Rays, bitewings, etc.) emailed to us at no later than one business day before their first visit to Richmond Family Dentistry.

If the records are not available at least one business day before the appointment or supplied records are determined to be inadequate, not readable, outdated, or cannot be accepted for other reasons, we reserve the right to do our own diagnostics in the office before patients can see Dr. Hart.

If you have any questions regarding these forms do not hesitate to call us at (804) 381-6238 or reach us by email:


I love Dr. Hart! So gentle and calming. I love that the office has no chemical air fresheners or these things...all natural and clean air! Dr. Hart supports an 'organic-type' lifestyle (in one word, this is the best way for me to describe) and I am delighted to have a dentist that shares my healthy lifestyle choices! I was looking for a dentist who would take out all the old amalgam fillings in a healthy and the safest possible way... THE BEST!!
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