Online Registration; Dental & Medical FormsFor 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 online forms PRIOR to their visit and arrival to the office:
- New Patient Online Registration Form
- Dental & Medical History & Insurance Information Online Form
- Consent Forms (Covid-19 disclosures; Financial Policy; HiPPA; CBCT consents)
- Informed Consent for Myofunctional Therapy
New Patient’s Dental RecordsNew patients can have their dental records (PAs, CBCT scans, X-Rays, bitewings, etc.) emailed to us at firstname.lastname@example.org 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at least one business day before the appointment or supplied records are determined to be inadequate, not readable, outdated, or cannot be accepted for other reasons, we reserve the right to do our own diagnostics in the office before patients can see Dr.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: email@example.com