Patient Forms

Younger woman and older woman smiling with healthy teeth.

Your Trusted Dentist in Charleston, WV

At Smith Family Dentistry, we are proud to help countless patients throughout the Charleston, WV area receive the superior dental care they deserve to keep their smiles healthy and bright. Dr. J. Christopher Smith and Dr. Richard Smith, DDS absolutely love getting to see our patients’ smiling faces every day. Whether you come to us for root canal therapy or as your pediatric dentist for your children, we hold to the same high standards of care each time you walk through our doors.

Complete Your Patient Forms

We’re so glad you’ve decided to trust Smith Family Dentistry for your dental care needs! The following forms will assist us with your care. Please complete the forms, and click the "Submit" button at the bottom of each form.

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.


Completing these patient forms is an important part of your patient experience. This will help us expedite the check-in process so we can quickly and efficiently provide you with the dental care you need and deserve, on a schedule that suits your busy lifestyle.

Book An Appointment With Your Charleston Cosmetic Dentist!

Smith Family Dentistry has been providing superior dental care for patients young and old for many years. As your trusted Charleston cosmetic dentist, we do so much more than cleaning and caring for your smile. We also proudly offer services like teeth whitening to provide you with a smile you can show off with confidence. Whether you need implant restoration, periodontal therapy, or treatment for sleep apnea in Charleston, we at Smith Family Dentistry are committed to providing you with exceptional service and compassionate care, each and every time you visit our office. We invite you to book an appointment today, or contact us with any questions. We can’t wait to welcome you into our family of happy patients!