Patient Forms

2-01

Preparing for your visit

For both Pediatric Dental and Orthodontic patients you may conveniently complete your New Patient Health History form online using our secure system.

Upon arrival, we will have your completed form available to sign. If you opt to fill out your forms in office please arrive 10 minutes before your scheduled visit.

We respect the security and privacy of your personal data and taken every precaution to protect it. If you need any help, please contact us. We can’t wait to meet you!

New Patient Forms

Almaden Valley pediatric dentist
elk grove orthodontist and pediatric dentist
Sacramento Pediatric Dentist and Orthodontist
Bes pleasant Hill Kids Dentist
Fair Oaks Pediatric Dentist

Uploading X-Rays

After submitting your information, you will have the option to upload X-Rays or other documents in these formats: GIF, JPG, PNG, TIFF, TIF, PDF and DEX graphic files OR Microsoft Word Documents (doc or docx file extension). Total of 5 uploads allowed not exceeding 60 MB.

The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Need to Send Us Your X-Rays?

Referring Offices

We are excited to help treat your patients, please choose a location, print & fax or email over the below referral form.

Almaden Valley pediatric dentist
elk grove orthodontist and pediatric dentist
Sacramento Pediatric Dentist and Orthodontist
Bes pleasant Hill Kids Dentist
Fair Oaks Pediatric Dentist

REFERRING OFFICES

We are excited to help treat your patients, please choose a location, print & fax or email over the below referral form.

Grab A Board, Take A Dive. ⁣

Join Our Mailing List!