Patient forms

To expedite the new patient process, feel free to download and print out the following PDF forms.  You can then complete the forms at your leisure and bring them in with you on your first visit.

New Patient Registration
This includes patient registration, medical history, financial policy, and HIPAA forms.

Other forms

Covid Protocol

Appointment Request

Medical History

Record Release


Tim & Margie

Just wanted to say to everyone out there in Wilmington, NC if you ever in need of a dentist or a looking to change your dentist, please try Dr. Jewell and his staff. We have been going to their practice for about 8 years and have never met a more thoughtful, professional, thorough and all-around nice man…

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