Cape Charles Dentistry
Cape Charles Dentistry
Cape Charles Dentistry
Cape Charles Dentistry

Make an Appointment Today!

Call us at: (757) 331-1589

 

Barney E Selph, DDS

726 Randolph Avenue

Cape Charles, VA 23310

Fax:757-331-1348

Email: drselphdds@gmail.com

 

Use our contact form to get in touch.

Office Hours

Monday, Tuesday, Wednesday  8AM to 4:30PM

Thursday  8:30AM to 5PM

 

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

Keep Your Teeth Healthy!

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

Get Social With Us

Patient Forms

If you are a new patient, please download and fill out the following forms before you come in for your first appointment. If you have dental insurance, bring your insurance information with you during your initial visit.

Patient Medical History Form

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.

Patient Medical History Form
Part 1
Scan0005.pdf
Adobe Acrobat document [355.8 KB]
Patient Medical History Form
Part 2
Scan0006.pdf
Adobe Acrobat document [313.8 KB]

Privacy Notice

Please read over and sign our Notice of Privacy Practices and Financial Policy. This form should also be brought to your first appointment.

Financial Policy/Privacy Notice
Scan0007.pdf
Adobe Acrobat document [488.1 KB]

Release of Records

Release of Records
Use this form to have your records sent to our office
Scan0008.pdf
Adobe Acrobat document [238.5 KB]
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