Patient Forms

Existing Patient Form

If you have insurance updates or would like to update your HIPAA forms, please download, complete and bring to your next appointment.

EXISTING PATIENT INFORMATION FORM

New Patient Form

Please complete the following new patient forms.

NEW PATIENT INFORMATION FORM

Contact Us

Send Us an Email

Our Location

405 Capitol St, Charleston, WV 25301, United States

Hours of Operation

Our Regular Schedule

Burgess Dental

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-7:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-2:00 pm

Saturday:

Closed

Sunday:

Closed