The new patient forms are available here for your convenience. Completing these patient registration and health history forms before arriving at our office will save you time at the examination appointment.
If you have insurance coverage, please bring your insurance card, form, or benefit pamphlet with you. Likewise, if you would like us to check into your orthodontic benefits and have the information ready for you when you arrive at your appointment, simply call the office at 925-272-0107 and we can gather the information over the phone.
Again, we welcome you to our practice and look forward to meeting you soon.
Health History Form
HIPAA Receipt
HIPPA Privacy Practice Notice