Location

Chantilly, Virginia

Mike Yeo Dentistry

Appointments with Dr. Smith

  • Wednesday and Thursday: 9:30 a.m.–5 p.m., with a lunch break from 1–2 p.m.
  • Saturday: 10 a.m.–2 p.m.

(703) 488-9921

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Before your first appointment

Your first visit includes a dental examination, X-rays, and a review of your health history.

Answer one section at a time, then save or print your completed form.

Fillable PDF · 3 pages · Printable

Download and save a copy before filling it out. You can also print it and complete it by hand.

Bring your completed form to your first visit, or email it in advance to drsmith@johnsmithdds.com.

Before booking, ask about the appointment fee and whether X-rays are charged separately.

If you have been referred, mention your dentist's name and the concern they want assessed. Ask how to arrange any records the office needs.

Tell the team about any concerns over discomfort or cost when you schedule your visit.