Family Dentist Eldersburg Sykesville Carroll County

Patient Forms

 

Top 10 Dentistry Clinics in Eldersburg 2016
Dr. Spencer S. StCyr, DDS has been recognized as one of the top Eldersburg Dentistry practices.

 

 

New Patient Forms

FORMS

Permission slip for treatments for children, students, that are dropped off or drive themselves to our office without a legal guardian. If you need cannot be with your child during their dental visit, please fill out the Guardian Permission form and send it with them.

Amalgam Silver Fillings:

For more information regarding amalgam fillings, click here

Blue Cross Federal Plan Participants:

 

Authorization and Consent To Send Unencrypted Patient Information by Email and Other Electronic Means:

 

NEW PATIENT FORMS

New patients, for your convenience we have placed our new patient forms on this website.

Please print all six forms below. Fill out the registration and history forms. Fill out the new patient survey so we understand your expectations and prior dental experiences. Read and then sign the privacy practices and policies documents. Then bring all six forms with you to your first visit.

 

If you do not already have Adobe Acrobat PDF Reader installed on your computer,
please go to Adobe and download the Acrobat Reader before opening the documents listed above.

 

 


Progressive Family & Cosmetic Dentistry
Serving the dental needs of families throughout Carroll County for over 15 years.

Our dental offices are located in the Eldersburg / Sykesville area just over the Carroll County line.
We are convenient to Baltimore County, Carroll County, Howard County, and Baltimore City.

Providing experienced, compassionate dental services for the communities of Eldersburg, Sykesville, Marriottsville, Finksburg, Mount Airy, Taylorsville, Glyndon, Reisterstown, Owings Mills, Deer Park, and surrounding areas.

 

Conveniently located in South Carroll on Oklahoma Rd. (at the intersection of Rt 26 Liberty Rd, Oklahoma Rd, and Ridge Rd, with the Eldersburg Commons Shopping Center, McDonald's, and Shell Gas Station).
Our driveway is on Oklahoma Road opposite McDonald's and the Oklahoma Road Middle School (click here for driving directions).

 

Phone: 410-795-0101   ~   Fax: 410-795-0165