Patient Information

New Patient Forms

Franklin Dental Associates offers online forms you can download and fill out before coming to our Rocky Mount, VA dentist office. We know it’s hard to get away from work and school to visit the dentist, so we make it more convenient so you don’t have to fill out paperwork in our waiting room.

You can download our new patient forms below, print them out, fill them out whenever you like, then bring them to your first appointment. We’ll be able to start your hassle-free exam immediately. Call 540-483-5241 if you have any questions about our forms. We’re happy to help!

Download our New Patient Forms

Payment Options

We provide peace of mind through patient-friendly dental services, as well as payment options.

We accept:

• Cash
• Checks
• Credit cards
• We participate with the following insurance companies: Anthem, Delta, Cigna, Ameritas, and Medicaid for patients under 21.
• We accept veterans who are part of the Community Care Network
• CareCredit financing, which allows you to make interest-free monthly payments without any upfront costs.

Please let us know as soon as possible if you cannot make your appointment. If you cancel less than 24 hours before your appointment, a broken appointment fee of $50 is possible.