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2290 Statesville Blvd., Salisbury, NC 28147
Mon - Thu 8AM - 5PM • Lunch 12:45 PM - 2PM

Patient Forms


Yang Family Dentistry is always happy to accept new patients! For your convenience, you can complete your medical history information before you come to your dental appointment. This online form is HIPAA compliant and is secure as shopping online. You will notice a lock icon at the bottom of your web browser.

Medical History Form

Step 1 of 4

  • Patient Information

  • Date Format: MM slash DD slash YYYY
  • Your info is secure- we use SSL!
  • Person to contact in case of emergency (ICE)

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