Patient Forms
Thank you for choosing Georgia Dental Medicine as your dental home. The details of your care are very important to us, and we always want to have accurate information on file for you and your family.
Georgia Dental Medicine Notice of Privacy Practices: Please review our Notice of Privacy Practices and download a copy for your records.
Registration Forms
for Current Patients and New Patients
To save time at your appointment, please complete your registration forms in advance using one of the options below:
Option 1: Secure Text Message Link
If you would like to complete and submit your forms via a secure link, please Call Georgia Dental Medicine (770) 973-6494 to request that a link be sent to your mobile phone.
Option 2: Download/Print Forms
You may download/print our registration forms below and bring the completed forms with you to your appointment. If you are a New Patient, please plan to arrive 15 minutes early so we can process your registration forms.
Please select the appropriate form group below: (be sure to print/complete each form in the list)
Current Patient Update
Additional Forms: Complete only as needed
Doctor Referral Form:
Have you been referred to Georgia Dental Medicine of Marietta by another provider? Please download and complete our Doctor Referral Form to bring with you to your first appointment with Dr. Chris Anderson.
Transfer of X-rays to or from Our Office:
Temporomandibular Joint (TMJ) Forms:
Please bring your completed form(s) to your first appointment at Georgia Dental Medicine.
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TMJ Facial Pain Questionnaire .pdf
If you are scheduled for a TMJ/TMD Evaluation with Dr. Chris Anderson, please download and complete the TMJ Facial Pain Questionnaire. -
TMJ Trauma Questionnaire .pdf
If you have a history of jaw or facial trauma, please also complete the TMJ Trauma Questionnaire.
Additional Items to Bring to Your Dental Appointment:
- Dental Insurance Card (if applicable)
- Photo ID
- List of Medications & Supplements you are currently taking
- Physician & Pharmacy contact information
We look forward to seeing you soon!
Georgia Dental Medicine, the office of general and cosmetic dentist Dr. Chris M. Anderson, is located at:
1225 Johnson Ferry Road, Suite 660, Marietta, GA
Please do not hesitate to Contact Georgia Dental Medicine if you have questions about dental care for yourself or a family member.