Patient Registration

  • Thank you for your interest in the endodontic office of Dr. Gordon L Barkley, III.

A comprehensive medical and dental health history will be completed before each initial visit. Please arrive 15 minutes early to complete necessary paperwork or download the paperwork below and bring it to your appointment.

Please bring a list of any prescribed and over the counter medications with you, a copy of your current insurance card, and a referral form from your general dentist. We will gladly see patients without a referral form to our office.

Download the necessary paperwork below.

Patient Registration
Medical History