We look forward to servicing you.  Call us at 803 255-0200.  Our smile managers are eager to meet you.  Our office hours are Monday thru Thursday 8:30 – 1pm and 2pm – 5pm.  On Fridays, we are available from 8:30am – 12 Noon. Feel free to complete and bring with you to your appointment.

Patient Information Forms

Forms for patients we have not seen for more than 6 months:
	Consent for Use & Disclosure of Health Information
	Notice of Privacy Practices
	Medical History Update
	Acknowledgement of Receipt of Notice of Privacy Practices

For Patients requesting x-rays:
	Consent for Use & Disclosure of Health Information

New Patient Forms (please bring completed forms with you to your 1st appointment):
	Patient Information
	Informacien del Paciente (For Spanish Speaking Clients)
	Patient Dental History
	Acknowledgement of Receipt of Notice of Privacy Practices