Text or Call To Book An Appointment | 423-899-1112| Voted Best Cosmetic Dentist In Chattanooga 2018, 2019 & 2020!

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  • Home
  • About
    • About Us
    • Ellen Standefer McOmie, D.M.D.
    • Mark D. McOmie, D.M.D.
      • Public Speaking Dental Seminars
    • Tori Dixon Hall, D.M.D.
    • Insurance and Financing
    • New Patient Forms
    • Technology
  • Treatments
    • Cosmetic Dentistry
      • Teeth Whitening
      • Cosmetic Dental Veneers
      • Gingival Re-Contouring
      • Tooth Bonding
      • Invisalign and Clear Correct Aligners
      • Smile Makeovers
    • Restorative Dentistry
      • Restorative Dental Bridges
      • Restorative Dental Crowns
      • Restorative Dental Implants
      • Tooth Colored Fillings
      • Dental Inlays and Onlays
      • TMJ/TMD
    • General Dentistry
      • Cavity Treatment
      • Tooth Extractions
      • Endodontics Root Canals
      • Oral Surgery
      • Orthodontics
      • Periodontics
    • Preventative Dentistry
      • Dental Checkups
      • Teeth Cleanings
      • Preventative Dental Sealants
      • Velscope Oral Cancer Screenings
      • Fluoride Treatments
      • Oral Hygiene Instruction
  • Smile Gallery
    • Dental Case Studies
    • Veneers Gallery
    • Dental Implants Gallery
    • Dental Crowns and Bridges Gallery
    • Teeth Whitening Gallery
    • Full Mouth Reconstruction Gallery
    • Dental Trauma Gallery
    • Cosmetic Gingival Recontouring
    • Resin Bonding Gallery
    • ClearCorrect Gallery
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New Patient Forms

Home About New Patient Forms

Be Prepared For Your First Appointment With New Patient Forms

These forms are for New Patients, which can be completed prior or upon arrival to our Chattanooga, TN office to save you time.  If you have any questions please feel free to call the office, our number is 423-899-1112.

Patient Registration and HIPAA Consent

HIPAA consent form Click Here To Download

Patient Medical History

dental patient registration form Click Here To Download
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Appointment Today! 423-899-1112

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  • Ellen Standefer McOmie, D.M.D.
  • Mark D. McOmie, D.M.D.
  • Tori Dixon Hall, D.M.D.
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McOmie Family dentistry

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5999 Shallowford Road
Chattanooga, TN 37421

Text or Call Us 423-899-1112

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