For your convenience, our patient forms are available online. We invite you to complete and electronically submit them before your appointment with our dentists in Haymarket, Virginia. This will make your visit more streamlined and efficient. We take your privacy seriously, and these forms are secure.
We will need X-rays for your first appointment with us, and will take diagnostic photos that document what your teeth actually look like on the first day we see them. If your X-rays were taken within one year, please contact your previous dental office to have electronic files sent to us securely. Unfortunately, without X-rays, the doctor cannot complete an exam and your insurance will charge you additional fees to re-take them. You will have to sign a release form that you can only get from them. Please note that we do not accept dental records via regular email. We treat your private dental health information the same way as your physician’s office. We look forward to meeting you!
Feel free to contact Awesome Smiles Dental Center today for more information and to schedule a visit with Dr. Tontra Lowe and Dr. Emoke Basa.
Click the links below to fill out your patient forms using a secure browsing session.
Existing Patients (Update Patient Forms for 2022):