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Patient Dental Forms from Dr Bray and Dr Young

Patient Forms

Dental forms are provided for your convenience. Please click on the form below, download, and print to complete.

We accept forms via mail, hand delivery or e-mail prior to your first visit.

Email forms to: office@brayandyoung.com

Mailing Address:
2 Lester Court
Statesboro, GA 30458

To download a copy, please use the links below:

Patient Registration Form

Adult Medical and Dental History Form

Child Medical and Dental History Form

Records Release Form

HIPAA Notification of Privacy Policy