(540) 249-1849

Patient Forms

Patient Forms

Going to the dentist can be an overwhelming experience, especially on your first dental visit. Let us put your concerns and anxieties to rest. Our goal at Heresi Dental Care is to make every patient experience as comfortable as possible.

To make your visit as pleasant and brief as possible, there are a few things you should bring with you. Please bring any dental X-rays from the last six months to your first appointment.

With just a few simple forms, we’ll ask for relevant medical history, any medications you might be taking, your dental history, and any dental insurance coverage you may have.

Want to get a head start? Download the new patient forms below.

These documents are in Adobe PDF format. If you’re unable to read PDF files, please  download free Adobe Acrobat Reader here.

Find Us! Get Directions

Our Happy Patients

"I love the staff, they all made me feel as comfortable as possible.Both Dentists are very compassionate😊"

Bell B.

"Excellent service. I went in for cleaning and a new crown and the office was quick, professional and very friendly staff."

Eddie M.

"Very happy with my visit. The staff is so kind and caring. Dr Heresi is awesome! He is very gentle during procedures and goes out of his way to be sure you are comfortable. Great, great team!"

Amy P.
We're here to help you get the perfect smile!
Have Questions? Call Us Now (540) 249-1849  OR   Schedule Your Visit!
Map Call Contact
Us
Contact Heresi Dental Care Today!
Close
form
Close form

Ready to Schedule an Appointment with Us?

Leave Us A Message
Tap To Call
With a Dental Certified Specialist