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Patient Forms

Please read the important forms regarding treatment at our prosthodontist’s office in Raleigh, NC:

New Patient Forms

Before visiting us at Premier Prosthodontics, please fill out the following online forms with your information and health history. Both are very important for us to provide you with the best possible care in a safe way:

  1. New Patient Information
  2. Medical History
Insurance & Financial Policies

Our doctors and staff are proud to deliver the finest and most comprehensive prosthodontic services available. In order to assist you with the investment in your dental health, please review, print, and sign the following forms:

    1. Patient Financial Policy
    2. Insurance Policy
Patient Privacy

These notices describe how health information about you may be used and disclosed and how you can get access to this information. Please review them carefully – your privacy is important to us:

  1. Notice of Privacy Practices
  2. Acknowledgement of Receipt of Notice of Privacy Practices
Release Form

Should we need one of your medical providers to release medical history to us, please review, print, and sign the form below:

  1. Patient Release Form
Premier Prosthodontics:
Advanced Aesthetic and Implant Dentistry

Welcome to Premier Prosthodontics: Advanced Aesthetic and Implant Dentistry in Raleigh, NC. Our team is led by Dr. Hugh Murphy. Together, we provide comprehensive restorative and aesthetic treatments to help our patients achieve healthy and beautiful smiles.

Dr. Murphy is a board-certified prosthodontist and Diplomate of the American Board of Prosthodontics. He earned his dental degree from the University of Southern California and specializes in treating patients with complex needs and exceptionally high expectations.

To request an appointment with Dr. Murphy, fill out our online form or call (919) 510-8886.

Raleigh Office

3820 Ed Dr
Ste 100
Raleigh, NC 27612

DIRECTIONS
(919) 510-8886