New Patient Forms

For your convenience, new patient forms are available in Adobe Reader format for printing and completing before your first appointment.

Patient Information - Please fill information to the dotted line PDF file/29k

Dental and Medical Health History - Please complete with as much detail as possible.  This form will be updated annually or if there are any changes. PDF file/87k

Office Policy PDF file/15k

Informed Consent - Information for the patient of the nature and risks of a proposed treatment, including no treatment or observation only PDF file/21k

HIPAA - Health Insurance Portability and Accountability Act (notice on how we handle the privacy of your health information) PDF file/27k

Facts About Fillings - Distributed by the Dental Board of California (advantages and disadvantages of different dental materials) PDF file/482k

To view PDF files, download Adobe Reader