New Patient Info

New Patient Questionnaire

In an attempt to make your visit to our office as efficient as possible, please fill out the New Patient Questionnaire before you visit.

Payment Info

As a condition of your treatment by this office, financial arrangements must be made in advance. We depend upon payment from our parties for the costs incurred in their care and the financial responsibility on the part of each patient must be determined before treatment. We will discuss financial options with you before rendering treatment.


CareCredit is a personal line of credit for healthcare treatments and procedures for your entire family. It works like a credit card but it has two advantages. It can only be used for healthcare services and you can get No Interest* financing every time you use it.


Dental insurance is designed to help offset the cost of dental care. Insurance estimates provide a table of allowances that will assist you in determining your approximate out-of-pocket expenses.

Cancellation Policy

We ask for at least 48 hours advance notice for canceling or rescheduling an appointment; otherwise a $50 fee may be assessed to your account. Note: All Cancellation fees must be paid prior to scheduling another appointment.

Leesburg Dental

602 S King St
Suite 302
Leesburg, VA 20175

Phone: 703-777-2442

Hours Of Operation

Mon - 8am to 5pm

Tues - 10am to 7pm

Wed - 8am to 5pm

Thurs - 10am to 7pm

Friday 8am to 1pm