Lauren Chapman DDS | Chapman Implant & Comprehensive Dentistry | New Patient Forms

New Patient Forms

North Raleigh Dentist

For your convenience, our dental team offers the ability to complete and submit your new patient forms online.  Once you click the link below, you will be taken to a secure site to enter your patient information and medical history.  Offering online forms are also a key part of our commitment to be as paperless as possible.  Once established as a patient, you will be asked periodically to confirm and update your information.

If you prefer to complete your new patient forms in the office, please arrive 10-15 minutes early to give yourself some extra time to do so.

The information you provide  will be handled confidentially and follow all laws regarding Health Insurance Portability and Accountability Act (HIPAA) and Patient Identifying Information as well as our office privacy policy.



Click below to fill out our patient forms.

Existing Patient Update

New Patient Information

New Patient Medical History

New Patient Dental History

New Patient Acknowledgment of
Receipt of Notice of Privacy Practices

New Patient Insurance Information
and Financial Policy

New Patient Communication Release and
Consent for Internet Communications

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Dentist in North Raleigh

8321 Bandford Way, Suite 107
Raleigh, NC 27615

(919) 782-7333

New Patient Forms

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