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:
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
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.
- Patient Registration (pdf – opens in a new tab / window)
- Dental History (pdf – opens in a new tab / window)
- Medical History (pdf – opens in a new tab / window)
- New Patient Survey (pdf – opens in a new tab / window)
(Tell us about your expectations and previous dental experiences.)
- Notice of Privacy Practices (pdf – opens in a new tab / window)
- Financial & Office Policies (pdf – opens in a new tab / window)
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 20 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 care 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).
