Forms

New Patient Forms

Click a file name to download a PDF document.

Print out the PDF and fill in your information. Bring these PDF documents with you to your dental appointment. Please download and read our financial and privacy policy statements and our appointment cancellation policy.

Dental Registration and History  

Medical History

Release of Dental X-Rays

Statement of Financial Responsibility

Medicaid and Health Choice Information

Notice of Privacy

Acknowledgement of Notice of Privacy

Cancellation and Broken Appointment Policy

Consent for Use and Disclosure of Health Information

 

CONTACT US

Dr Carlos Privette & Associates

970 Northwoods Drive
Cary, NC 27513 United States

Phone: (919) 465-0799
Fax: 919-465-0797

HOURS

Mon. 8:30 am - 12:00 pm
Tues. 8:00 am - 5:00 pm
Wed. 7:00 am - 5:00 pm
Thur. 8:00 am - 5:00 pm
Fri. 7:00 am - 5:00 pm
Closed Sat. & Sun.

OUR LOCATION