New Patients

Patient Forms

Complete your forms in advance — online or on paper. We’ll make sure you’re set up before you arrive.

The fastest path

Our online registration covers everything we need — contact details, medical history, and insurance information — and takes about ten minutes.

Online Registration

Prefer paper?

If you’d rather fill out paper forms, give us a call and we’ll email or mail them to you, or you can come in 10 minutes early and complete them in our reception area. To open or print PDF forms, you’ll need a free PDF reader installed on your device.

Need help?

Some questions on the medical-history form get a little technical. Skip anything you’re not sure about — we’ll fill it in together when you arrive.

More for New Patients

Questions about your forms?

540-342-8781

Why patients on Orange Avenue choose Northeast Roanoke Dentistry

Dr. Rameen Chaudhry, DMD is calm, unhurried, and trained at Case Western Reserve University with a General Practice Residency at Rutgers — and he believes the most important skill in dentistry is listening. Patients across northeast Roanoke, the 24012 corridor, Hollins, Garden City, and Vinton choose Northeast Roanoke Dentistry on Orange Avenue NE because every visit feels like a real conversation, not a sales pitch. We talk about cost up front, accept most major PPO insurance plans, and offer the Virginia Dental Club membership for patients without insurance — so cost is never the reason a smile waits. Open Monday through Friday, 8am to 5pm at 2913 Orange Ave NE, Roanoke 24012. Call 540-342-8781 or request an appointment online.