Patient Forms

If you would like to save some time at your appointment, we invite you to fill out our patient forms in advance. Simply download, print, and fill out the forms below, then bring them with you for your visit with Dr. Smith, our talented dentist in Alexandria, Virginia. We welcome you to contact our friendly dental team with any questions; we are ready to help!

Download Patient Form


Financial Options

Our friendly dentist and dental team are dedicated to making your dental experience as pleasant and streamlined as possible. We file insurance claims and accept assignment of benefits for most PPO plans. Please call us for a free, no-obligation determination of coverage provided by your particular dental insurance plan.

We accept payments in cash, checks, and credit cards (VISA and MasterCard only) in payment for any portion of your treatment not covered by insurance. For more information on dental insurance and our other financial options, please feel free to contact our dental office in Alexandria, Virginia today. Dr. Smith and his team are happy to assist you.