New Patient Forms

We are happy to offer our patient forms online. Please feel free to print and fill them out at your convenience before your visit.

New Patient Registration

Please download, print and complete this form before your first dental appointment.
Click here to download (66 KB)

Financial Agreement

Please download, print and complete this form before your first dental appointment.
Click here to download (890 KB)

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Click here to download (229 KB)

HIPAA Form

Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.
Click here to download (295 KB)

 
If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader:

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  • Monday
    Tuesday
    Wednesday
    Friday
    Saturday

  • Morning
    Afternoon
    Early Evening

Our Office

Good Neighbor Dental

12051 Chestnut Branch Way #C3
Clarksburg, MD 20871
Map & Directions
 
Phone: 301-355-4789
 

Office Hours:
Monday10:00am-7:00pm
Tuesday 9:00am-6:00pm
Wednesday10:00am-7:00pm
ThursdayClosed
Friday 10:00am-7:00pm
Saturday*9:00am-2:00pm


* Every other week