ACWORTH DENTIST DANIEL LEE DMD, PC | ACWORTH DENTAL | PARTIAL DENTURES | DENTURE REPAIRS
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New Patient Forms

If you prefer you may print all forms and bring with you on your first visit, or fax them to us at (770) 974-4950.
You may also email the forms to [email protected]
You may click on the files below to access PDF versions of the documents:
new_patient_form.pdf
File Size: 12 kb
File Type: pdf
Download File

medical_history_form.pdf
File Size: 15 kb
File Type: pdf
Download File

accountresponsibility.docx
File Size: 13 kb
File Type: docx
Download File

hippa.docx
File Size: 13 kb
File Type: docx
Download File

Contact Us

Daniel Lee, DMD, PC | Acworth Dental
4427 Carnes Street, Acworth, GA 30101
Ph: (770) 974-4146  
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Hours: Monday - Thursday 8:00 AM - 5:00 PM 

  • Home
  • The Team
  • First Visit
  • Location
  • Forms
  • Services
  • Contact