2651 Brambleton Ave., Roanoke, VA 24015
540-283-0959
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Patient Information Forms
Please click to download & print our office forms listed below to complete before your first appointment. You can also download & print all our other forms & surgical instructions.
Ourhelpful team is here for you.
Save time by bringing your completed forms!
If you’re not able to complete our forms online, please arrive at least 15-minutes early to allow time to complete the medical/dental health questionnaire and the patient information form. Be sure to list all medications with dosages and any natural supplements, attaching an extra sheet if necessary.
Also, bring your insurance cards for us to copy and if your general dentist has given you a written referral or x-rays, please remember to bring them with you to your appointment.
To speed up your visit with us, you are welcome to download, print and fill out these forms before you arrive. You may bring them with you or email them to us at frontdesk@acharyaperiodontics.com. If you have any trouble downloading any of these forms, please call our office at (540) 283-0959. Any of our staff members will be happy to assist you.
SCHEDULE AN APPOINTMENT FOR PERIODONTAL CONSULTATION.
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Website & Office Privacy Policies
Post-Surgical Instructions
Diagnosis and Management
A thorough examination and accurate, specific diagnosis is the foundation of effective treatment.
Non-Surgical Treatment
Very often, early stages of periodontal disease are effectively treated with non-surgical periodontal therapy.
Surgical Treatment
When necessary, Dr. Acharya and her team can walk you through a surgical treatment plan to restore healthy gums and teeth.
Dental Implants
Dental implants are a common procedure of permanently replacing missing teeth without affecting other neighboring teeth.