1059 Eden Way North, Chesapeake, VA 23320   |   757-547-2266


Before Your First Visit

New patients are required to completed the following forms before being seen in our office.  You can save time by dowloading and completing these forms prior to your first visit.

We are required by law to provide you with our "Notice of Privacy Practices" This is a requirement as spelled out in the Health Insurance Portability and Accountability Act (HIPAA), 45 CTR Parts 160 and 164 (the "Privacy Regulation"). Health Care Providers at Greenbrier Dental Center have adopted privacy policies regarding usage of patients’ right to privacy.

Please click the links below to review the New Patient Forms.

Once you have reviewed them you can download and print the HIPAA Notice of Privacy Practices, that along with a Patient Registration, Health History and Financial Policy form for each patient.

Please fill in the appropriate areas, sign them and bring them when you come for your first visit.