Patient Registration

Secure Online Patient Registration Form

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online oral surgery registration form

Please call with any questions or to schedule a consultation with one of our Oral Surgeons!

 

 

 

See what our current patients are saying about us!

Clark Holmes

5 out of 5 stars based on 26 reviews.

Our Latest Patient Testimonial by Kayla E

Dr. Holmes is one of the best dentists/oral surgeons I've ever used. I work at a dental office and was referred to him by my boss for a tumor removal and bone grafting in 2013. He is always very punctual and very detailed about treatment plans. I will definitely recommend him to anyone. His staff at Southside are very sweet ladies. They are so kind and will always talk to you while you wait.

- Kayla E

5 out of 5 stars on

Our Latest Patient Testimonial by John

Thanks for a great visit, much easier than I thought

- John

5 out of 5 stars on

Our Latest Patient Testimonial by keyonna m

i would definately choose the overall staff and dr.again....definately thank you guys sooooo much for taking care of my baby(14)daughter and we did not know what to expect with this whole procedure.

- keyonna m

5 out of 5 stars on

Our Latest Patient Testimonial by tanika

the staff was very professional.

- tanika

5 out of 5 stars on

Our Latest Patient Testimonial by Donna M

Couldn't have asked for better care for my son. They were very professional but warm and friendly. Would highly recommend them to anyone looking for work to be done.

- Donna M

5 out of 5 stars on

Our Latest Patient Testimonial by Sibo M

I had a great experience everyone was very nice!

- Sibo M

5 out of 5 stars on

Our Latest Patient Testimonial by belinda m

Dr. Clark did 5 extractions for me.He along with his staff was awesome .Cant wait to go back to him for my jaw surgery consultation.

- belinda m

5 out of 5 stars on

Our Latest Patient Testimonial by Tiffany S

Dr, Clark did my reconstructive jaw surgery over a decade ago, and I still tell people about him any chance I get. Being able to smile changed my life. I was just looking up your website today to link to a friend who's husband may need the same type of surgery and thought I should take a moment to write a review and let you know how grateful I am for what you did. You rock, Dr. Clark!!

- Tiffany S

5 out of 5 stars on

Our Latest Patient Testimonial by Jeff

I had four teeth extracted and a bone grapht conducted simultaneously. The surgery was flawless, and I felt no discomfort during the procedure. Additionally my discomfort immediately after the surgery and for the following few days was almost nonexistent ! Dr. Miller has examined me three times during the first month post surgery to make sure I was healing properly. I couldn't imagine having more thorough care.

- Jeff

5 out of 5 stars on

Our Latest Patient Testimonial by Kyle

Dr. Holmes and his staff are the best at what they do. They should take pride in how well the do their work.

- Kyle

5 out of 5 stars on