Jeffrey J Tibbs DDS PA
The Dental Practice of Dr. Jeffrey J. Tibbs

New Patient Forms

Save time waiting in our office by filling out necessary forms online. Feel free to give us a call if you have any questions.

Authorization to Release Medical Records

Communication Authorization Form

Dental History Form

Informed Consent Form

Medical History Form

New Patient Registration Form

Have Questions? Get in Touch
If you have difficulty using our website, please email us or call us at (336) 765-7477
View the ADA Accessibility Statement
Are you worried or have questions/concerns about your dental appointment during COVID-19?  Please see our COVID information at the bottom of this page.