Online Patient Registration

& Medical History Forms


You may preregister with our office by downloading and filling out our Patient Registration & Medical History Forms. On your first visit to our office, please bring the completed forms. The security and privacy of your personal data is one of our primary concerns and we take every precaution to protect it.


Our online form uses the latest Adobe Acrobat Reader plug-in to conveniently submit the form from home or work. Please download the free plug-in from Adobe's web site if it is not already installed on your system. It is important that you have at the latest version of the plug-in to successfully use our online form.


Online Reputation

by Jay M. via Judy'sBook 2010-10-29
"The staff is always friendly and professional. From the moment you arrive you are met with smiles and a concern to be the best they can be. From root canals, crowns, and routine check-ups there is no one else I would trust. I live in Durham but am happy to travel to Greensboro knowing I will have quality work from quality people.

Great Dentist I highly recommend
by A Google User via google 2010-08-06
Dr Sullivan and staff are great. They have a comfortable and at home feeling. If you have any fears even with having just your teeth cleaned, they have a way to help you relax.

Dr. Sullivan and his staff are great.
by A Google User via google 2011-01-15

David R. Sullivan DDS - Greensboro Dentist
Rated: 5 Stars By 3 Reviewers
Mon. 8:00am – 5pm
Tue. 8:00am – 5pm
Wed. 8:00am – 5pm
Thu. 8:00am – 5pm
Fri. Special Appointments Only