Patient Forms

Dentists, Charlotte, North Carolina

Click here to download patient forms.

If you are planning your first visit with our office, we request you please complete our health questionnaire prior to your appointment. This form is provided by the link above so you may fill it out at your leisure. Please remember to bring it with you to your appointment. If you have any questions, please contact our office at 704-442-7175.


Samuel J. Randall, DDS
6842 Morrison Blvd.
Suite 202
Charlotte, NC 28211
Phone: 704-442-7175