Patient Forms

New patient? Please download and fill out the following forms when you come in for your first appointment.

New Patient Paperwork
NEW PATIENT PAPERWORK %282%29.pdf
Adobe Acrobat document [108.7 KB]
Adult New Registration
ADULT NEW PATIENT PAPERWORK.pdf
Adobe Acrobat document [146.8 KB]
A Guide to Dental Coverage for Pregnant Mothers
Over 21 Pregnancy_OnePager.pdf
Adobe Acrobat document [179.4 KB]
Dental Records Release to Another Office
Record Release to another office.pdf
Adobe Acrobat document [710.6 KB]
Release Records to CDC
Release Records to CDC.pdf
Adobe Acrobat document [707.9 KB]
Extractions Post-Operative Instructions
Extractions Post.pdf
Adobe Acrobat document [14.8 KB]
Information on Injuries to Primary Teeth
Primary Tooth Injury.pdf
Adobe Acrobat document [12.5 KB]

Contact Info

Phone: 434-293-9300

 

259 Hydraulic Ridge Rd

Charlottesville, Va 22901

 

Fax: 434-973-9310

 

Email: clittle@cdcva.org

 

Hours of Operation

Monday - Thursday

8am - 5pm

 

During inclement weather, Community Dental Center follows the City of Charlottesville school closing schedule.

 

When City Schools are on a 2 hour delay, we will open at 9:45

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