Dental Patient Registration

You may preregister with our office by filling out our HIPPA Compliant Secure Online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration Form
PPE Consent Form
Financial Agreement Form
Patient Screening Form

For more information about how to register as a patient, any of the other services we offer, or to schedule a consultation appointment, call our office in Silver Spring, MD at Elsabet H. Tekle, DDS Phone Number 301-384-7800.