Southern Pines OMS Center Online Patient Registration

Oral Surgery Patient Registration In Pinehurst NC

Please see the patient registration/forms section of our website.  You will be able to complete most of your registration forms online.  All information is HIPPA/PHI protected and secured.

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 Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration

If you are unable to complete your registration forms on our website, you will be provided with the forms on your first visit.  The following forms are required to be completed:

  • Patient Demographic form
  • Patient privacy act form
  • Patient consent to photos form
  • Patient financial and assignment of benefits form
  • Patient Health History form
  • Appropriate Informed Consent Forms and Anesthesia Forms

By filling out our patient registration form in advance, we are able to provide you with a faster and more convenient experience upon your first visit to our office. If you have any questions about the patient registration process, please call us at Southern Pines Oral & Maxillofacial Surgery Center Phone Number 910-725-1403.

Office Hours

Monday through Thursday:   7:30 AM - 5:00 PM
Friday:   8:00 AM - 2:00 PM

Call Southern Pines Oral & Maxillofacial Surgery Center Phone Number 910-725-1403 today to schedule your consultation with Dr. Lombrano

Thank you for choosing Southern Pines OMS Center. We strive to deliver the best diagnosis and treatment that our practice has to offer. We believe that these goals can be met through a continuous and open dialogue between you and our entire team.