MON-THU: 8-5 | FRI: CLOSED | CLOSED 12-1 FOR LUNCH

Patient Forms

Dental Patient Forms

To make your visit to Dr. White’s office as efficient as possible, we’ve placed some of our most used forms online. These PDF’s can be printed and read or completed at home. You must have Adobe Acrobat Reader to open these forms. Click here to download the free version of Adobe Acrobat Reader.

 

New Patient Information

HIPAA Acknowledgement

Extraction Care

Meet your friendly Lafayette Dentist & Staff

Practicing General Dentistry & Family Dentistry since 1995

"This is my quote as a staff member."

Dr. Charles White II

Family Dentist

"This is my quote as a staff member."

Jennifer Harris

Dental Hygienist

"This is my quote as a staff member."

Denise "Neecy" Cobb

Dental Assistant