Tri-State Center for Advanced Implant Dentistry and Periodontics, LLC Online Patient Registration
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Note to Patient: Upon filling out your first name, last name, email and at least one phone number field (a valid home or cell phone) a button will appear in the upper right corner titled “Save and Exit” . This button allows you to save and exit your form to complete at a later date. The system will send a registration email to the email provided on the form, so that you may setup a login to go back and finalize your registration form online.
After you submit the form, you will have the opportunity to securely upload and transmit images of you insurance card. Please call our office with any questions: Hagerstown Office Phone Number 866-739-6868
New Patient Information
Thank you for choosing Tri-State Center for Advanced Implant Dentistry and Periodontics, LLC. We strive to deliver the best diagnosis and treatment that our practice has to offer. We believe that these goals can be met through a continuous and open dialogue between you and our entire team.