3632 Common Street
Lake Charles, LA
337.478.4022

Forms

Download the forms below and fill out before your first visit. All forms are in PDF format. If you do not have a PDF viewer you can download one here.



Consent Form (PDF)

Download & Print


New Patient Welcome (PDF)

Download & Print


Notice of Privacy Practices (PDF)

Download & Print


Acknowledgement of Receipt of Notice of Privacy Practices (PDF)

Download & Print

Latest News

Congratulations to Dr. Churchman and Dr. Roberts on being voted in Acadiana's Top Dentists list of 2015 by peers!

Address & Hours

3632 Common St.
Lake Charles, LA 70607
337-478-4022
Mon - Thurs | 8am-5pm, Friday | 8am-12pm

Services

  • Diagnostic Exam
  • Dental Cleanings
  • Bondings
  • Fillings
  • Extractions
  • Implants
  • Restoration
  • Sealants
  • Crown & Bridge
  • Veneers
  • Tooth Whitenings
  • Dentures