Patient
Forms

Thank you for selecting us as your orthodontic care team and welcome to our practice!  Please rest assured that it is our goal to provide your orthodontic treatment both thoroughly and efficiently. 

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

Our Services

Gummy Smile

There is no clearly defined definition of a gummy smile, as the aesthetic appeal of any smile is a highly subjective ..

Braces

Traditional metal braces work by using a system of brackets and wires to place gentle pressure on your teeth. 

Retainers

Retainers have long been part of orthodontic care, but are far too often approached as an afterthought.

Invisalign

Invisalign is a great alternative to traditional metal braces. The system uses patented clear plastic..

Adult Orthodontics

There are differences between adult and child orthodontics, but excellent results are possible for either group. 

Surgical Orthodontics

Retainers have long been part of orthodontic care, but are far too often approached as an afterthought.

TMJ Specialist

Your jawbone and the joints that connect it to your skull play numerous roles in your daily life, even though you might not think.

Orthodontic Emergency

Temporomandibular joint disorder, commonly called TMJ or TMD, is a condition in which improper joint alignment causes.