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**New Patient Form**

**This form is only if you are visiting our office for the first time. Please print and bring to your appointment. You may wish to scan both sides of completed form and email it to us at  Don't forget to bring your dental insurance card/ info.


Current Patient Update                  Dr. Reagin with Patient

This form is for returning patients who need to update their information.





Payment Options

You can pay for your office visits and any treatments by cash, check, credit or debit card at the time of treatment. We also accept many major dental insurances. At this time we are unable to accept AM Better, Peachstate and Medicare/Medicaid. To discuss your payment options or insurance coverage, please call (770) 939-7134 in advance of your appointment. Please bring your insurance card with you to your appointment.