Patient Registration Forms

Let’s Get Started

Thank you for choosing Knoxville Center for Oral & Maxillofacial Surgery for your oral health and/or aesthetic needs! Please pre-register with our office by filling out our secure, HIPAA-compliant patient registration form below prior to your visit. If you have any questions, don’t hesitate to give us a call at (865) 410-3075.

Online Patient Registration Form
Pay Your Bill

After you have completed the form, please make sure to press the “Complete and Send” button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Ready to Get Started?

Whether you have functional, oral health or aesthetic concerns, our Knoxville Oral and Maxillofacial Surgeon can help. Take the first step towards a healthier, more confident you by scheduling an appointment today!

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