Patient Registration

We are looking forward to seeing you at your first visit. In preparation for your appointment, all forms must be filled out prior to your appointment.

If you have any questions or trouble, please contact our office at Callahan Dental Phone Number (301) 948-1212 and we will be happy to assist you. 

For our New Patients:

• New Patient Registration Form
• Insurance Information Form
• Health History
• Dental History
• HIPAA Acknowledgement
• New Patient Agreement
• Financial Agreement
• Release of Dental Records

For our Existing Patients:

• Patient Registration Update Form
• Insurance Information Form
• HIPAA Acknowledgement