Midtown Dental welcomes new patients! When you visit our practice for your first visit, we will ask you to complete our new patient forms. To help you save time, we have provided our patient forms online for you to complete prior to your visit with Dr. Seth Rumley, or Dr. Raj Prajapati. Simply click on the links below, download the forms, fill them out, and bring them with you to your first appointment. If you have any questions about our patient forms, and to schedule your appointment with our dentists for your dental care in Raleigh, North Carolina, we welcome you to contact our office. We are always happy to help!

Online Forms are only available through the Google Chrome web-browser. (mobile version not supported)
Click here to download Google Chrome.

(Complete And Print)
New Patient Form
(Complete and Submit Online)