To schedule an appointment please call our office at 410-647-4269 or email firstname.lastname@example.org.
The Tooth Place
22 Truck House Rd. Suite 3
Severna Park, MD 21146
Business hours are:
Monday – Thursday: 8 a.m. – 5 p.m.
Friday: 8 a.m. – 4 p.m.
Saturday: 9 a.m. – 1 p.m. (occasional)
Please print and fill out the R1 and Consent forms and bring them to the office at your first visit.
This form is an agreement and explanation of our privacy policies and requires a signature.
Consent Form – Date: 02 Nov 2015 | Size: 52 KB (PDF)
Patient Medical History
This form is to provide your medical history and must be completed and signed.
Patient Medical History – Date: 02 Nov 2015 | Size: 19 KB (Microsoft Word Document)
This document contains information about our office policiesa nd requires a signature.
Office Policies – Date: 02 Nov 2015 | Size: 16 KB (Microsoft Word Document)
To view, complete, or print PDF forms you will need Adobe Acrobat Reader installed on your computer. This software can be downloaded at www.adobe.com
Forms last updated 11-02-2015