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  • 5284 Lyngate Court, Burke, VA 22015

  • Mon-Thur: 8am-5pm / Fri: 8am-12pm

New Patients

Tips for a successful first visit

First visit

Your child’s first visit to our office is important, and we will do whatever it takes to make sure your child has a comfortable, positive experience. To help each child, we offer a guided tour of the office and Olivia the Octopus and Louie the little red fish tag along while we explore. While on the tour, we will see illustrations that tell the story of Louie’s first trip to the dentist.

In addition to the fun story, we invite each child to participate in a treasure hunt, which helps them to locate important areas of our office, including the waiting room, the gaming area, the x-ray room, the sterilization lab, a dental chair, and the treasure chest.

The tour and treasure hunt have been thoughtfully designed to help your child relax and have fun at the dentist.

We believe the first step to establishing a dental home is earning the trust of each child and their parents. That is what the first visit to Pediatric Dentistry of Burke is all about.

When your child feels comfortable, we will schedule an exam visit, which will allow us to establish your child’s dental records and begin educating your child on proper oral care practices and techniques.

New Patient Medical History Form

Fill It Out Online Print It Out

Supplemental Infant/Toddler Questions

Supplemental Adolescent Questions

Medical/Dental History

New Patient Information

For your convenience, you may print the new patient forms at home and bring them to your first appointment.
Financial Policy

New Patient Demographic Form

Notice Of Privacy Practices

Patient Referral Form


At Pediatric Dentistry of Burke, we like to have fun. Our office was specifically designed to engage our patients and make them feel comfortable at the dentist. Some amenities we offer include:

  • Original illustrations depicting the first dental visit
  • Gaming Center
  • TVs to distract and entertain at every treatment chair

Payment options/insurance

To keep your child’s dental care affordable, we gladly accept most insurance plans., and we offer third-party financing with CareCredit.