Fill out the form below to request an appointment!

Name *
Phone *
Are you a new patient? *
Date *

Office Hours

Monday & Tuesday : 8am–6pm
Wednesday : 11am–7pm
Thursday : 8am–6pm
Friday & Saturday : 8am–5pm


101 Shattuck Way
Suite 3
Newington, NH 03801

Email & Phone
T: (603) 431-4601
F: (603) 431-1741


Cancellation Policy: To avoid a $50 fee, notify us at least 48 hours prior to your appointment to cancel or reschedule.

Dental by Design would like to make your first dentist office appointment even faster by using these printable new patient forms below. For more information on our New Hampshire dental services and how to make best use of these forms, please call our office.

Patient Registration Option

It’s More Convenient
Once you make an appointment, our office will ask you to provide patient registration details such as name and address, responsible party, consent for treatment, etc. You can save time by printing and filling in these forms yourself.

Bring The Forms With You
After you’ve completed the medical history and new patient forms, simply bring them with you on the day of your visit. Alternately, you can also fax them to us at (603) 431-1741 prior to your dental appointment — if you prefer.

Although it’s not required, bringing completed forms with you will save time spent at our office and help make your first appointment less troublesome. If you have any problems downloading the forms, be sure to call our office and we will gladly send them by mail, or fax them to you.

Just so you’ll know, our online registration form  and website authorization forms are PDF document files. You must have the current Adobe Acrobat Reader (free) installed on your machine to view & print the forms.

Click to download our New Patient form »