Patient forms

New patients

Patient Forms

Want to save time at your appointment? Download and fill out the Patient Health History form to maximize your visit at Zsambeky, Chaney, & Associates. We know how difficult it is to take time out of your day for a dental appointment, so we want to make it easier for you.

closeup of woman filling out a medical record

Keep your visit fast and simple by downloading and completing the necessary forms before you arrive. We’ll try our best to get you in and out so you can enjoy the rest of your day.

Scan to download patient portal app

If you cannot open PDF files, you can download *Adobe Reader for free.

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what our patients say

“I love this group of people. From the office staff to the medical staff - they are the best! Kind, gentle and up on the latest in dentistry. I highly recommend Zsambeky Chaney & Associates!”

- Ann F.

“Dentists and staff are always friendly and professional. The dental care I get here is superb. In over twenty years of being a patient, my experiences have always been great!”

- Lisa H.

“The best dental office in Concord, NC. If you plan to move here, choose this office. You won’t be disappointed. Dr. Zsambeky and his staff are the best!”

- Virginia C.

“This team keeps you laughing while they take care of your dental needs, which can sometimes be a dreaded experience. I am greeted by my first name when I enter and I don’t have to wait long in the lobby. The office staff helps me plan more complex visits in conjunction with my insurance and what is doable for me.”

- Derek F.


Your Perfect Dental Partner

Monday - Thursday: 7am-5pm
Friday: Appointment Only