New Patient Forms

Are you new to our dental practice? Would you like to expedite the sign-in process for your first appointment? Below you will find the forms we require all new patients to fill out. In order to speed up the check-in process, please download, print, and fill out the forms before your appointment. This will help save both you and our office valuable time.


To download these forms, you will need access to Adobe Reader. If you have questions or need help with the forms, please call us at 209-369-0294 or use our online form to send us a message. We will be happy to help. We can’t wait to see you in our office!

Patient Information

Notice of Privacy Practices

Financial & Appointment Policy Form

Acknowledgment of Receipt of Notice of Privacy Practices

New Patient Medical History Form

Online Contact Form
We look forward to hearing from you. Thank you for taking the time to fill out this form.
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