Patient Forms

All new patients must complete the digital forms prior to the first visit in our office. There are 3 forms total. When you click the link for a form, a new window will open for you to enter your information. Once you hit Submit, the window will close to indicate it has been sent to our office. 

If you press submit and nothing happens please check the forms to make sure you have not left a required field blank (Marked with an *). Any red text on the page will indicate a section that needs to be complete. Please call us at 910-256-8486 if you have any questions or to verify we have received your paperwork.  

Patients opting to complete the paperwork in our office should arrive 30 minutes early to use our tablet to complete the forms. 


New Patient Digital Forms



Notice of Privacy Practices PDF

For a limited time, Cook Periodontics is offering new patients a complimentary full set of x-rays with every comprehensive exam!*

Call today to schedule!

*Excludes 3-D CBCT Scan