Patient Forms

You may access the following forms to assist us with your care. Please print and fill out the following forms, then bring them to your appointment.  All new patients should arrive 15 minutes prior to their scheduled appointment time.

Orthodontic Forms

Pediatric Dentistry Forms

For Existing Patients


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*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.

Barbara J. Utermark, D.M.D.

  • Barbara J. Utermark, D.M.D. - 4469 B Columbia Rd., Martinez, GA 30907 Phone: (706) 860-5884
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