1600 Deo Dara Drive,Suite 1
Birmingham, AL 35226 

Tel (205) 822-8155
Fax (205) 822-8085
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ALL COPYRIGHTS RESERVED FOR BRIGHTS DENTAL CENTER, LLC                                                                                 WEBSITE DESIGNED AND MANAGED BY STRONGTOWER GRAPHIC DESIGN
NEW PATIENT DOWLOADABLE FORMS
The following Information/Registration form is provided as a courtesy and convenience to our new patients. 
 
To expedite your new patient visit to our office, you may download the
New Patient Registration form here as well as Medical History Form, Consent Form and Privacy Policy. Please provide as much information as possible. 
 
Please bring the completed form with you when you come for your appointment.  If you have any questions, please call the office at (205) 822 8155.
The New Patient Registration Form requires the Acrobat Reader plug-in. Click the button below to download your free reader.
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- New Patient Registration Form
- Nueva forma de registro paciente
 
- Consent Form
- Forma del consentimiento
 
Note: Click to download all necessary forms.  Once you have completed download close browser to return to Page.
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WELCOME / OUR PRACTICE / DENTAL SERVICES / F.A.Q / PAYMENT OPTIONS / REGISTRATION FORM / ASK DR. RO /  HOURS & LOCATION / SCHEDULE APPOINTMENT / SMILE GALLERY
- Medical History Form
- Forma del historial médico
 
- Privacy Policies
Roleen Bright, DDS