Patient Forms

Make Your Visit Easy

Once you make an appointment, our office will ask you to provide patient registration details such as name and address, responsible party, consent for treatment, etc. You can save time by printing and filling in these forms at home where information is handy and convenient.

Bring The Forms With You

After you've completed the medical history and the complete set of new patient forms simply bring them with you on the day of your visit. Alternately, you can also fax them to us at 619-444-0668 prior to your dental appointment -- if you prefer.

Federal law also requires us to give our patients a Notice of Privacy Practices. A link to this form is located below.

Although it's not required, bringing completed forms with you will save time spent at our office and help make your first appointment less troublesome. If you have any problems downloading the forms, be sure to call our office and we will gladly send them by mail, or fax them to you.

IMPORTANT: You must have the current Adobe Acrobat Reader (free) installed on your machine to view & print the forms. Click the icon below to get the latest reader.

CLICK HERE to download our patient, health history, insurance and consent forms.

CLICK HERE to download the Dental Board of California’s Dental Materials Fact Sheet.

CLICK HERE to download our Notice of Privacy Practices.


PATIENT INFORMATION
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