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Falls Church Dental Care
7115 Leesburg Pike, Suite 205
Falls Church, VA 22043
Phone: 703.534.3444
Fax: 703.534.3944
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Make your first dentist office appointment even faster by using these computer fillable new patient forms.

Fill Forms It's More Convenient
Once you make an appointment, our office will ask you to provide patient registration details such as name and address, responsible party, consent for treatment, etc. You can save time by downloading, completing the forms on your computer, and printing these forms yourself.

Bring The Forms With You
After you've completed the medical history and new patient forms, simply bring them with you on the day of your visit. Alternately, you can also fax them to us at 703-534-3944 prior to your dental appointment -- if you prefer.

Although it's not required, bringing completed forms with you will save time spent at our office and help make your first appointment less troublesome. If you have any problems downloading the forms, be sure to call our office and we will gladly send them by mail, or fax them to you.

Just so you'll know, our online registration form is a PDF document file. You must have the current Adobe Acrobat Reader (free) installed on your machine to view & print the forms.

New Patient Forms

  • To Download our Patient Form and the Notice of Privacy Policy, please click Below
form Privacy Policy

COVID-19 Forms
  • To Download our COVID-19 Patient Screening and Patient Supplemental Informed Consent forms, please click Below
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Adobe PDF Reader
  • To download the Free Adobe PDF Reader, please click below.
Download Free Acrobat Reader