Patient Registration

For your convenience, you may download, print and fill out the following forms and bring them to your appointment

Patient Registration

Medical History


Financial Form


Protect the health and beauty of your smile! Call Us Today!
Crozet Family Dental Phone Number 434-823-4080 Schedule an Appointment Map & Directions
Our office hours are Mon 7am-7pm, Tue 8am-5pm, Wed 8am-5pm, Thu 10am-7pm, & Fri 8am-5pm.