Charles P. Thomas, Jr., D.D.S., P.C.

"Changing the World, One Smile at a Time"

Patient Forms

patient forms

Please take a minute to print and fill out the patient information form before your first appointment:

Patient Forms

  • Patient Form (Adult Medical Dental History) PDF
  • Patient Form (Adult Medical History) PDF
  • Patient Form (Child Medical Dental History) PDF
  • Patient Form (Child Medical History) PDF
  • Patient Form (Dental Insurance) PDF

Retainer Design Options

  • Retainer Design Option - 1 PDF
  • Retainer Design Options - 2 PDF
  • Retainer Design Options - 3 PDF
  • Retainer Inlay Options PDF

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