Online Dental Registration System
Dr. Mercado her team of dental professionals are dedicated to making your visit as comfortable and efficient as possible. To allow us to get to know you, please pre-register with our office by filling out our online New Patient Registration forms prior to your visit.
Use our online Patient Portal to fill out New Patient Registration forms.
Please fill out and complete all forms (see list below) prior to clicking “SUBMIT”. This will allow our secure, HIPAA-compliant software to import the information.
- Patient Information
- Health History
- HIPAA Notification
- HIPAA Acknowledgement
Please fill out our online HIPAA Release of Information form. Call our office if you have any questions.
On your first visit to our Fort Mill SC dental 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.
If you have any questions, please do not hesitate to call our office: Monarch Dentistry of Gold Hill Fort Mill Office Phone Number 803-547-7779.