Olive Chapel Family Dentistry
Dustin J. Prusik, DDS

New Patient Forms

Save time waiting in our office by filling out necessary forms online. Feel free to give us a call if you have any questions.

 

COVID-19 Screening Questions

Records Release Form

New Patient - Adult

New Patient - Child

Have Questions? Get in Touch
If you have difficulty using our website, please email us or call us at (919) 335-6133
View the ADA Accessibility Statement
COVID-19 Update:  Olive Chapel Family Dentistry is open normal business hours for routine care.  We ask that you call our office for an appointment as we are currently not accepting walk-ins. We have increased measures to promote safety and social distancing within our practice.  Stay safe and we look forward to seeing you soon!