Patient forms


Welcome all new patients!

In advance of your visit, please print and fill out these forms, and bring them to your appointment.

I just wanted to thank the three of you for the awesome experience I have every visit! I’ve never been anywhere else with a more friendly and welcoming staff, and I just love you guys! Hope you all have a great week and see you in October!

Taylor McMillan

Lynchburg, VA

Being a single mom, getting braces for the boys was a surprise. And I think it was awesome to have them with Dr. Black. She is so great in answering all of our questions. Would highly recommend. Great staff!

Paulette D. Ford

Lynchburg, VA

Dr. Black and her staff provide outstanding dental services delivered with the care and patience you would only expect from family or a lifetime friend. Their concern for their patients is obvious and shows through each stage of the orthodontic process.

Karen Camper

Evington, VA