3903 Emerson Ave, Parkersburg, WV

(304) 424-7343

Wilfong Dental Wilfong Dental
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NEW PATIENT FORMS

PRINT OUT AND COMPLETE THE FORMS PRIOR TO YOUR VISIT

Home / Resources / NEW PATIENT FORMS

New patients are required to complete these forms at the time of “check-in” for their first appointment.  For your convenience, simply print them out and complete the forms in your spare time prior to this appointment.

  • Patient Registration
  • Medical History
  • Financial Policy
  • HIPAA Acknowledgement

All of our patients should be familiar with our HIPAA Notice of Privacy Practices. Please read the following document:

  • HIPAA Notice of Privacy Practices

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Services

  • Crowns and Bridges
  • Root Canals
  • Extractions
  • Partial and Full Dentures
  • Teeth Brightening/Whitening
  • Porcelain Veneers and Bonding
  • Invisalign®
  • Botox®

Contact

  • 3903 EMERSON AVE, PARKERSBURG, WV
  • P: (304) 424-7343
  • F: (304) 917-3761
  • 8AM – 5PM MON-WED
    8AM – 4PM THUR
    8AM – 1PM FRI
Wilfong Dental is committed to ensuring that this website is accessible to the widest possible range of people.
If you have any trouble using this website due to language or disability please call (304) 424-7343 for personalized service.
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