Patient Forms

Don't want to spend fill out paperwork before your dental appointment? The below forms can be completed before your visit to Eastfield Pediatric Dentistry to reduce your stress in the dental office.
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Printable Patient Forms

The below patient forms can be printed and completed before your visit to Eastfield Pediatric Dentistry. Please bring the completed forms with you during your appointment.

Patient Intake Form

Click here to access our patient intake form to download, print, or complete ahead of time.

Formulario de admisión del paciente

Haga clic aquí para acceder a nuestro formulario de admisión de pacientes y descargarlo, imprimirlo o completarlo con anticipación.

Dentist Near You


8631 Arbor Creek Drive, Suite D3
Charlotte, NC 28269


(704) 875-9075



Monday: 8:30 AM - 5:00 PM
Tuesday: 8:30 AM - 5:00 PM
Wednesday: 8:30 AM - 5:00 PM
Thursday: 8:30 AM - 5:00 PM
Friday: 8:30 AM - 1:00 PM
Saturday: Closed
Sunday: Closed

Excellence in Dental Care for the Entire Family

Contact Us Today for an Appointment

Don’t wait, schedule your child's appointment with our friendly dental team today and keep your smile healthy and bright.