Make an appointment today.
910-354-2680
Open 7 days a week.
Dental Emergencies Se Habla Español

Patient Forms

For your convenience, New Patient Forms are provided below. To expedite your first visit, please review, print and complete these documents, bringing them with you to your appointment. Please note, a separate Patient Registration Form and Medical History are required for each patient.

If you have any questions regarding these forms, please do not hesitate to contact us at 910-354- 2680 or jjelic@dayandnightdental.com.

Also feel free to bring your forms and our friendly staff will be happy to answer any questions you might have or help you complete them when you arrive.

If you do not have the ability to print the New Patient Forms, they are available at our front desk and will be provided upon arrival.

We look forward to seeing and serving you.