Dentist North Wilkesboro Mobile Registration Forms and School Schedule
Mobile Dental Clinic/Wilkes County School Schedule
 
We are available to treat your child over the summer!
 
***IF YOUR CHILD IS A PATIENT AT A SCHOOL WE HAVE ALREADY LEFT, AND YOU HAVE NOT RECEIVED NOTICE THAT THEIR TREATMENT IS COMPLETE, OR IF YOUR CHILD HAS EMERGENCY DENTAL NEEDS, PLEASE CONTACT THE MOBILE CLINIC AT 336-903-7303.***
 
You can download mobile clinic registration forms here. Please complete both the registration form and the HIPAA form to allow us to see your child.
 
 
If you have been told that your child needs a referral to see a specialist (such as an oral surgeon, pediatric dentist, or orthodontist) please complete this release of records form.
 
Forms can be delivered in person to the mobile clinic, to our West Park office, or by fax to 336-903-7313.
 
 
West Wilkes High School
 
East District:    
 
CB Eller Elementary School
East Wilkes Middle
Ronda Clingman 
Roaring River
East Wilkes High
 
Bridges Charter School
 
North District:      November-December
Traphill
North Wilkes High
North Wilkes Middle
Mountain View
Mulberry
 
 
West District:       
Boomer Ferguson
Mount Pleasant
Millers Creek
West Middle
West High
 
Central District:
North Wilkesboro Elementary 
CC Wright Elementary 
Moravian Falls 
Wilkesboro Elementary 
Central Wilkes Middle
Central Wilkes High
 
Bridges Charter School
 
Wilkes Early High School/College
 
If you would like your child to be treated at school on the mobile dental clinic, complete both sides of the registration form sent home with your child.  After your child's exam, we will send home a consent form that must be signed and returned in order for treatment to be completed.  As treatment is done, you will also receive progress reports about your child's visits to the mobile dental clinic.