Contact
Telephone
540-904-4644
Hours |
Monday: |
7:30 am - 5:30 pm |
Tuesday: |
7:30 am - 5:30 pm |
Wednesday: |
7:30 am - 5:30 pm |
Thursday: |
7:30 am - 1:00 pm |
Friday: |
8:00 am - 4:00 pm |
Location
Dr. Michelle Mayerchak, D.M.D.
4207 Colonial Avenue S.W.
Roanoke, VA 24018
Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is important to us.
New Patient Forms
To save time, you can print and fill out our new patient and medical history forms before you come to our office on your first visit. Please print the forms below, fill them out and bring them with you for your appointment.
After reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it and bring it in, too.
New Patient Form
Medical History Form
Acknowledgement of Receipt of Notice of Privacy Practices