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Plage Dentistry
  • Our Staff
  • Our Services
  • New Patient
  • Financing Available
  • Blog
  • Contact Us
  • Covid Update
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New Patient Forms

  • New Patient Forms

    If you would like to go ahead and fill out your paperwork before your first visit feel free to do so. It will make things go smoother on the day of your first appointment. You can download these files to your computer and then upload them with an inquiry or bring them with you to your visit. Thank you!

    Patient Registration

    Medical History Form

    HIPAA consent form (English)

    HIPAA consent (Spanish)

Contact Us

Feel free to contact our office with any questions. We look forward to making each visit to our office a positive experience.

  • Drop files here or
    If you would like to fill out your new patient paperwork online before your appointment, please upload the files here.
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910.762.4155

1802 New Hanover Medical Park Drive,
Wilmington, NC 28403

Aerial photography by Michael Plage • Managed by Dental Systems Optimization, LLC • Privacy Policy

Dear Patient, please read our message to our patients that highlight additional precautions and measures Plage Dentistry are taking.