We invite you to download and complete our new patient forms prior to your appointment at Potomac Dental Centre using the links below. By completing your patient forms prior to your appointment time, you will assure a prompt start time for your scheduled appointment and more time with our dentist, Dr. Everett Eklund. If you have any questions or need assistance, please call our dental office in Hagerstown, Maryland. Our dental team is happy to assist you.
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Patient Registration
Medical History
HIPAA Agreement
Financial Agreement
ADA Consent
COVID-19 Consent
Referral Program
Do you love visiting Potomac Dental Centre? Tell your friends and family. If you refer a new patient to our dental practice, we will add a $50 credit to your account. To learn more about our referral program, we welcome you to contact us today. We look forward to speaking with you.