Jazriel Cruz DDS
Jazriel Cruz DDS

Patient Forms

New patient? Welcome to our practice! Please download and fill out the following forms when you come in for your first appointment.

New Patient Forms (English)

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

New Patient Forms
English New Patient Form.pdf
Adobe Acrobat document [3.1 MB]

New Patient Forms (Español)

Por favor imprima estas formas, llenelas, y traigalas con usted a su primer cita. 

Spanish New Patient Forms
Spanish New Patient Form.pdf
Adobe Acrobat document [3.2 MB]

Get Social With Us

Make an Appointment Today!

Call us at: 540 371-7777 540 371-7777


Jazriel Cruz DDS

2405 Charles St.

Fredericksburg, VA



Our business hours

Monday - Thursday08:30 AM - 05:00 PM
Friday08:30 AM - 12:00 PM

Emergency care

Outside our regular business hours, please note our emergency care information.

Keep Your Teeth Healthy!

What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.

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