Dr. Durst Family Dentistry in Augusta, Wadley, and Harlem, GA
New Patient Forms

formIf you would like to complete your registration forms before you arrive, you may download them by clicking below. The new patient forms are in PDF format. If you do not have Acrobat Reader, get a free copy by clicking on the link below.

Adobe PDFNew Patient Registration Form (Acrobat PDF form)


Adobe PDFNitrous Oxide Informed Consent Form (Acrobat PDF form)


Adobe PDFAdobe ReaderInformed Consent for Oral Conscious Sedation (Acrobat PDF form)


Adobe PDFAuthorization to Release Records (Acrobat PDF form)


Adobe PDFHIPAA Consent Form (Acrobat PDF form)