Drs. Hollyfield, Perkins, and Thompson, Ltd
Oral Surgery
 
 
  • HOME
  • Patient Information
    • Introduction
    • First Visit
    • Scheduling
    • Financial Policy
    • Insurance
    • Privacy Policy
    • Online Videos
    • Patient Registration
  • Procedures
    • Dental Implants
    • Bone Grafting
    • Wisdom Teeth
    • Facial Trauma
    • Jaw Surgery
    • Pre-prosthetic Surgery
    • Distraction Osteogenesis
    • Oral Pathology
    • Cleft Lip & Palate
    • Platelet Rich Plasma
    • Impacted Canines
  • Meet Us
    • Meet Neil D. Hollyfield DDS
    • Meet Dennis W. Perkins DDS
    • Meet Brian C. Thompson DMD
    • Meet the Staff
    • Office Tour
  • Surgical Instructions
    • Before Anesthesia
    • Dental Implant Surgery
    • Wisdom Tooth Removal
    • Exposure of an Impacted Tooth
    • Extractions
    • Multiple Extractions
  • Referring Doctors
    • Referral Form
    • Study Club
    • Links of Interest
  • Contact Us
    • Marion Office
    • Abingdon Office
    • Wytheville Office

Patient Information

  • Introduction
  • First Visit
  • Scheduling
  • Financial Policy
  • Insurance
  • Privacy Policy
  • Online Videos
  • Patient Registration

Patient Registration

You may preregister with our office by filling out our 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.

Technical Note:

PC Users
Our online form use the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.

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Address: 645 Park Blvd • Marion, VA 24354 • Phone: 276-783-8131


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