New Patient Registration Form for Our Belmont Dental Practice

Please take the time to fill out our New Patient Questionnaire prior to your appointment.

In order to maintain confidentiality and respect your privacy - we ask that you bring this signed completed form to your first appointment.

If you have any questions or concerns, feel free to contact the office at 617.484.2431 and we will be happy to assist you.

We look forward to welcoming you to The Belmont Dental Group family.


Click Here for the New Patient Registration Form

Why Belmont Dental?

  • Offering Sedation Dentistry & Invisalign
  • Fast Emergency Care – Connect Anytime with Your Dentist!
  • Our dentists are Clinical Instructors at Harvard Dental School
  • Extended Hours on Weekends and Evenings
  • New Patient Referral Rewards Program - Refer a friend to receive Dental Gift Certificate to your account!
  • Free Parking

Contact Us Today

Invisalign Lumineers by Cerinate