New Patient Forms

To save you time in our office, you may print and fill out the forms below prior to your first visit.

Patient Information Form
Medical History Form

There Are Many Ways To Contact Our Office

Mailing Address

Lee Family Dentistry
2202 N. Berkshire Rd. Suite 103
Charlottesville, VA 22901

Phone
434-293-9916

Fax
434-293-3879

Contact Us Today
The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment or answer any questions that you may have.

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New Patient Forms

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