Patient Registration

Patient Forms:

• HIPAA Patient Privacy Act
• Notice of Privacy Practices Addendum
• *Patient Registration*
• Medical Health History
• *Patient Authorization Form*
• *Financial Policy*
• *Acknowledgement of Receipt of Notice of Privacy Practices*

 Prior to your initial dental visit at our office, please print out and complete the underlined forms posted above and bring with you. We will have you complete a medical history once you arrive at the office. If you need assistance, you may email our office at [email protected]. or call the office at Patrick Michel DMD PA Phone Number (336) 768-3314. Thank you!

What To Expect
Being well-prepared for your appointment will ensure that the dentist has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our Meet Our Staff page and familiarize yourself with our team.  We look forward to your first visit.