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Patient Forms

If you are a new patient to our office, the attached files contain our new patient forms that will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Please call our office if you have any questions at all.

Thank you

Health History Form 

Please print both pages, fill them out completely and bring them with you to your first appointment.

HIPPA FORM

Please sign the acknowledgment that you have received the HIPPA form and bring it with you to your first appointment.

X-Ray Release

You may use this release to request x-rays from your prior dentist.  Not all offices require a signed release form.


Other informational forms:

Theory of Abfractions

Mini Implants

 

Contact Us

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We encourage you to contact us with any questions or comments you may have. Please call 916-961-6810

11121 Fair Oaks Blvd|Fair Oaks, CA 95628|Map & Directions

Call: 916-961-6810