New Patient Forms

You may access the following forms to assist us with your care. You can either submit our new patient forms online or download, print and bring them in to your appointment.

Online Forms

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

Printable Forms

If you experience an error or would prefer to bring your form in to your appointment, please download and print the appropriate form below.

Office Hours
Monday - Thursday: 8 a.m. - 5 p.m.
Contact Information
Markham & Hair Dentistry
6415 Bannington Rd.
P.O. Box 472145
Charlotte, NC 28247
Phone: 704-541-1193
office@markhamandhairdentistry.com