Call Us: (336) 299-8530

Patient Forms

We want to welcome you to Jerry Reeves DDS family!

We are glad that you are interested in becoming a patient of Dr. Jerry W. Reeves’s Greensboro, NC dental practice. New patients are always welcome here. Everyone at our office is committed to making your visits pleasant and stress-free. You can count on our friendly, highly experienced staff to always provide the highest standard of dental care in a clean, state-of-the art environment. Your comfort is our top priority.

We look forward to seeing you soon!

Dr. Jerry W. Reeves and the team


Click below to download New Patient Registration Materials


Dental Insurance Benefits FAQ's

Oral Health Risk Questionaire

Registration Form

Medical History Form

Dental Insurance Benefit Form

Consent For Treatment Form

Release of Records Authorization Form

Authorization for Release of Information

Authorization to Release Health Information

Cancellation Policy Form

Notice of Privacy Practices

Acknowledgement of Receipt