(817) 592-5055

Patient Forms

Going to the dentist can be an overwhelming experience, especially on your first dental visit. Let us put your concerns and anxieties to rest. Our goal at 6 Day Dental & Orthodontics - Roanoke is to make every patient experience as comfortable as possible.

To make your visit as pleasant and brief as possible, there are a few things you should bring with you. Please bring any dental X-rays from the last six months to your first appointment.

With just a few simple forms, we’ll ask for relevant medical history, any medications you might be taking, your dental history, and any dental insurance coverage you may have.

Want to get a head start? Download the new patient forms below.

These documents are in Adobe PDF format. If you’re unable to read PDF files, please  download free Adobe Acrobat Reader here.

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Our Happy Patients

"We have used 6 Day since we moved to Roanoke. The staff is very professional and the doctors are extremely knowledgeable. Both of our kids got braces here and the experience was great. I would recommend 6 Day to anyone looking for a great dentist/ortho office, one-stop shopping."

Ron M. Ron M.

"The team members here at 6 Day Dental went above and beyond to fulfill my needs and keep me as a patient! I must say this is by far the most beautiful set of team members that have all stuck together for so many years and seeing the same friendly faces makes me feel so welcomed and at home. Thank you all for another enjoyable visit and special thanks to Courtney, Cristina, and Valerie for all your hard work and dedication you have shown over these last several years. Because of you all I make the 30 minute drive knowing I will leave completely satisfied and happy!"

Jarolyn A. Jarolyn A.

"By far the best dentist office in the DFW area. Very accommodating and friendly staff. My daughter had a root canal done and cap put on, they made her feel very comfortable. They quickly verified our insurance and were flexible with us on the out of pocket expense. We will definitely be back for more services!!"

Elizabeth B. Elizabeth B.
We're here to help you get the perfect smile!
Have Questions? Call Us Now (817) 592-5055  OR   Schedule Your Visit!
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