Patient Forms

For your convenience, we have uploaded the following Patient forms. Please print and fill all sections prior to your first appointment. Patient forms can also be filled while at the office. On an average it will take at least 15-20 minutes to fill these forms. Please plan on arriving accordingly to your first appointment. Please update us if there are any changes to your health status, insurance and/or contact information.
i

Patient Registration Form

English and Spanish
i

Office Policies

English – Page 1; Spanish – Page 2
i

Medical / Dental History

Print in Landscape only
i

Patient Care Instructions

For information only

What to expect at your first visit:

— Verification of personal information, health history and benefit plan / insurance coverage — Exam, X-rays, pictures, consultation and simple teeth cleaning (if applicable) — Topical fluoride (Kids), oral hygiene instructions and patient samples — Discuss treatment plan and insurance breakdown for payments — Follow-up treatment / recall visit appointment