Lake Ridge Dental Care - Click to go to the home page
Elizabeth A. Tarpley, DDS, PC
(703) 670-7071
 
13625 Office Place, Suite 102, Woodbridge, VA 22192
 
New Patients

Mission Statement/Office Philosophy

Our practice is working together to realize a shared vision of excellence. To fulfill this mission, we are committed to:

  • Listening to those we are privileged to care for
  • Exceeding expectations
  • Striving for continuous improvement
  • Providing the highest level of care
Directions and Parking
Click here for door-to-door directions to our office.

Feel free to call our office or email us with any questions.

What to Bring with you

Please Bring any records from previous providers.  Also, please fill out and bring along any medical and/or dental forms that are mailed to you.  We look forward to meeting you!

New Patient Appointment Request

Welcome new patients! To request appointment availability, please fill out the form below. Our scheduling coordinator will contact you to confirm your appointment. Fields marked with an asterisk * are required fields. The more you fill out here the less questions we will need to ask you later.
Existing patients, please click here for the existing patient appointment request form.

Is there a specific date that you would prefer?
,

What day of the week would you like to come in?


What time do you prefer?


Full Name*

Email Address*

Address

City

State

Zip Code


(At least one number required)*
Home Phone Number
( ) -
Select
Preferred number
Office Phone Number
( ) -
Cell Phone Number
( ) -

Birthday


Please describe the nature of your appointment :



Insurance Information
Name of Insurance Provider  
Group Number  
Patient ID  
Customer Service Phone #  


                    
Click just once please, your confirmation screen will appear in just a moment.


Please download, fill out, and bring the following forms with you on your first visit. All documents require Adobe Reader to view.

Patient Information Sheet

Dental History

Medical History

CONSENT FOR TREATMENT

If your child has an appointment with us, please include the following forms

Childrens dental hisory

Children's medical history

 
Sedation Dentistry
Have Anxiety about visiting the dentist? Sedation Dentistry can help. Read more about Sedation Dentistry here. Also read a reprint of the Wall Street Journal article "Did I Really Have a Root Canal?"
Wall Street Journal article link
Invisalign®
Breakthrough technology that lets you have the smile you've always wanted - without the hassle of braces.
Article by By Lisa Rein, Washington Post Staff Writer, Tuesday, September 23, 2008, regarding teeth grinding.