New Patient Forms
Before Your Visit
You'd probably rather spend your appointment talking with us than filling out a clipboard. New patients can complete their paperwork at home, whenever it's convenient. Your answers also let us review your health history before you arrive.
Your Forms, Sent Digitally
After you book, we send your new patient forms straight to you, so there's nothing to print or drop off. You can fill them out on your phone or computer whenever it's convenient.
If you can't find the forms or would like help filling them in, call (714) 282-2525 and our team will be happy to help.
What We'll Ask For
-
New Patient Registration
Your contact details and insurance information help us check your coverage before your visit and reach you about appointments.
-
Medical History
Please list your health conditions, medications and allergies so we can plan care that's safe for you. You're also welcome to mention dental anxiety or a difficult past visit, which helps us make your appointment more comfortable.
-
HIPAA Acknowledgement
This short form confirms that you've received our notice of privacy practices, which explains how we use and protect your health information.
If you're unsure how to answer a question, leave it blank for now and we'll go over it together when you arrive.