New Patient Forms

We want your visit to the Atlanta Center for Dental Health to be productive and convenient. Please complete these new patient forms online and click “submit.”

We know your time is valuable, so please complete all this information thoroughly now, so we can avoid time delays once you arrive or delays in insurance payments toward your care.

So pour yourself a cup of coffee, get cozy, and let’s get to know each other.

New Patient Forms

Finance and Insurance

Payment for services may be made with cash, personal check, or major credit card.

Before beginning any treatment, we will provide you with a detailed treatment plan that includes a breakdown of insurance coverage, if applicable. We love helping patients make the most of their insurance benefits. We are happy to participate in a number of PPO insurance plans and accept assignment of benefits, which will enable you to receive the care you need without having to pay the upfront cost and wait for insurance reimbursement.

Our patients may also select the option of interest free financing through CareCredit or the Lending Club. Prequalification may be completed online at or