Patient Forms

Printing the following forms, filling them out and bringing the forms with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please contact our office if you have any questions at all.


Credit Card Authorization Form

New Patient Form (Child)

New Patient Form (Adult)

CA Policy

Financial Policy

HIPAA

Treatment Consent Form (Veneers)

Treatment Consent Form (Teeth Whitening)

Treatment Consent Form (Scaling and Root Planning)

Treatment Consent Form (Implant Crown)

Treatment Consent Form (Filling)

Treatment Consent Form (Extraction)

Treatment Consent Form (Crown and Bridge)


Our Office


Sacramento

7230 S. Land Park Dr., Suite 123,
Sacramento, CA 95831
(916) 392-7110
(916) 392-7157
Get Directions

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.