New Patient Registration Form

Dr. Seth and staff are committed to providing you and your family with safe, gentle, high-quality dental care. We understand that you, or your child, may feel anxious about visiting the dentist. We are sensitive to your needs, and it is our goal to make you feel comfortable visiting our practice while providing the best care possible.

We are truly a paperless office. Now you can fill in online forms below at your comfort prior to your first appointment. Please be sure to submit your new patient intake forms online prior to arriving for your first visit. These forms must be completed before you are checked in. Completing them in advance will prevent the possibility of needing to reschedule in the event that you are unable to arrive in time to complete them before your scheduled appointment time.

  • Patient Information
  • Insurance Information
  • Medical History
  • VELScope Vx Exam Authorization
  • HIPAA Notice
  • Dental Office Policy
  • In case, you are unable to fill in online forms, please download and print forms and bring them in to your first appointment at our office, Riverwalk Smile Dentistry -Dentist in Rock Hill SC 29730. Thank you and we are looking forward to seeing you soon.

  • Download PDF forms
  • Please alert the office if you have a medical condition that may be of concern prior to treatment (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc.)

    The American Dental Association recommends visiting your dentist every six months for regular checkups and routine teeth cleanings to keep your teeth and gums healthy.

    We understand that you have a busy schedule, so when you’re preparing to visit the dentist, please remember that your appointments can last between 45 and 90 minutes.