Patient Forms

Please fill out the registration packet below if you are new to our office. There are 4 pages. Email the completed forms to information@evolveyoursmile.com or Fax to 804-716-2862.

Registration Packet

Please fill out the COVID Consent if you are an existing patient coming in for an appointment.

Covid-19 Consent Form

Click the link below to download our HIPAA Notice of Privacy Practices.

HIPAA Notice of Privacy Practices