Patient Forms

Before your scheduled appointment at Pike & Valega, DDS in Poolesville or Rockville, MD, we ask that you take the time to fill out our patient forms. The patient forms take just a few minutes to complete and will save you time on the day of your appointment. 

These forms help us gather valuable information, such as personal health and dental history, medication lists, and personal information that helps us provide you with high-quality dental care. Our patient forms are also used to gather insurance and billing information. All information is collected and stored in a safe, secure manner. 

If you have trouble accessing our patient forms or have any questions, feel free to contact us, and we will gladly help you set up your upcoming appointment.

Patient Registration Poolesville
Patient Registration Rockville

Start on the right path to a healthy, beautiful smile.

We don't just create beautiful smiles at Pike & Valega DDS in Poolesville and Rockville, MD — we provide our patients with the tools and knowledge they need to practice good oral health for a lifetime.

Patient Reviews

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Patient Reviews

“Given my long history of being in the dentist chair, I do believe the service and quality of this dental team is excellent! I’ve lost count of how many crowns and root canal’s I’ve had but hands down this is the best looking crown I’ve gotten so far.”

Wanda H

“Dr. Pike is the GREATEST!!! He saved my tooth!!! He saw me right away, he was so kind and calming. I’m not the greatest patient, I was so scared. My tooth broke and I was definitely in pain. I needed a root canal. He knew exactly what to do.”

Lori A

“I have a fear of dentists but I love this place. I feel so comfortable at every visit. Ellen and Dr. Pike are warm and treat their patients like family. I am so glad I found this practice. I recommend them whole-heartedly!”

Ridwon B

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