Skip to main content
(803) 547-4466 Schedule An Appointment
signing a document

Patient Forms

In order to make your first appointment as smooth and efficient as possible, we offer all patients the opportunity to complete their paperwork online prior to their first appointment. It’s simple, fast, and easy! Please note: if the patient is under 18 years of age, these forms must be completed by a parent or guardian.

All of our patient registration forms are 100% secure and comply with all federal privacy and security requirements.

Please follow each of the links below and complete each form one time. It is important that you complete each of the forms below.

Patient Registration

Medical History

Authorization for Release of Information

Notice of Privacy Policies  (Please note: this form is a confirmation that you have had a chance to read and review our privacy policies)

Financial Policies

Our Client Reviews

Gold Hill Dentistry

4.4 / 5.0

Based on 97 reviews


Very professional, thorough, gentle and kind!


I have always had great care. The staff is just wonderful, friendly and caring. Thank you for all you do!


The staff is always warm, helpful, professional and expert! I love this practice.


The entire staff are incredibly kind and Dr. Kasik is a very talented dentist.


Friendly and accommodating staff scheduled an appointment within 24 hours of calling in due to broken filling. Competent and professional staff completed the repair in less than an hour, perfectly!

Contact Us

2848 Pleasant Road, #104
Fort Mill, SC 29708

Phone: (803) 547-4466