Patient Forms

Do you wish there was a way to save time during your first appointment? If so, we're happy to help you! For your convenience, we have provided new patient forms that you can download below. Be sure to fill these out and bring them with you to your appointment. If you have any questions about the forms or your dental care, please give us a call at 540-886-1979 and talk to a member of our team. We are happy to help!

Download Forms

REGISTRATION

HEALTH HISTORY

FINANCIAL POLICY

DISCLOSURE HEALTH INFO

REQUEST FOR

DENTAL RECORDS

“My dental experience with Dr. White was excellent! I arrived early to complete some necessary paper work and was taken back for care immediately. My procedure was pain free and the results were great! All staff are friendly and very professional!” - Steven

Request a Time that Works for You!

Thank you for visiting the dental practice of Dr. Jesse Myers, D.M.D. and Dr. Alan J. White, D.D.S. online! Our dentists provide world class dentistry at valley prices! We are excited to work with you and your family members to resolve all of your dental needs. Call us or schedule your dental appointment today! We're honored to help you become proud of your smile!

Address

601 Greenville Avenue

Staunton, VA 24401

Phone

540-886-1979

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Become a

patient for life

I've been a patient of Dr. White's for over 15 years. I've never

been disappointed. - Karen

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