Kathryn J. Savitsky, D.M.D., P.A.
15825 John J. Delaney Dr., Ste. 150
Charlotte, N.C. 28277
Tel: 704.540.2800
Fax: 704.540.8900
Office Hours:
Tue-Thurs 9-5
Fri: 9-3
Better
Business Bureau®
A+ Business Rating
Proud Member
A+ Business Rating
Proud Member
FORMS
ON YOUR initial office visit, we
will require the completion of two forms:
1) PATIENT HISTORY and Information Form
and
2) PRIVACY
ACT and Billing Information Form
WE REALIZE that your time is valuable. We have
added these two
forms for you to print, complete, and bring with you on your
initial
visit, if you wish. Both forms available in .pdf and .doc formats. Adobe® Reader is available at:
1) PATIENT HISTORY and
Information Form:
Please choose to download this
form in either format below:
PATIENT HISTORY and Information in PDF
or
PATIENT HISTORY and Information in DOC
2) PRIVACY ACT and Billing
Practices:
Please choose to download this
form in either format below:PRIVACY ACT and Billing Information in PDF
or
PRIVACY ACT and Billing Information in DOC
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Kathryn J. Savitsky, D.M.D., P.A.
15825 John J. Delaney Dr., Ste. 150, Charlotte, N.C. 28277
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