Patient Registration

New Patient Forms

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Oral Surgery online patient registration button

Print Forms

Please click on the links below to download and print our office forms.


Call or email us today with any questions!

Cumberland Oral & Maxillofacial Surgery Phone Number 301-722-3205 Request Appointment

Our office is located at 1715 Frederick Street, Cumberland, MD. 21502.

Office Hours

Monday:   9:00am - 5:00pm
Tuesday:   9:00am - 5:00pm
Wednesday:   9:00am - 5:00pm
Thursday:   9:00am - 5:00pm
Friday:   9:00am - 5:00pm