Patient Forms

We look forward to meeting you and your child at the first appointment! To prepare you for a successful visit with your kid's dentist, we encourage you to complete forms at your convenience prior to your appointment. In order to do so, please email us at info@CarolinaPedo.com or call (919) 570-0180 to reach a front representative who may assist you in scheduling and setting up your webportal account. You will then be able to complete some of your forms electronically (computer and tablet-supported format only). 

If it is most convenient for you to print forms and complete them at home, you may find a downloadable version of our New Patient form below:

New Patient Information Form: (English) (Spanish)


CPD Appointment Infographic for North Raleigh/Wake Forest Office: (English) (Spanish)
CPD Appointment Infographic for Downtown Raleigh Office: (English) (Spanish)

Notice of Privacy Practices - PDF
Notice of Privacy Practices (Spanish) - PDF

 

ready to get
started?

(919) 570-0180
Monday - Friday 6:45AM - 5PM