For your convenience, please download and fill out the electronic forms below, before your first appointment (click links below) and email to the office you will be visiting.

Medical History Form (Eng)

Medical History Form (Esp)

Notice of Privacy Practice

Dental Risk Assessment Questionnaire

Oral Health History Questonnaire

Visit Documentation

If you’re unable to open PDF files, you can get Adobe Reader® for FREE.

Filling out the forms:

  1. Position the pointer inside a form field and click. The I-beam pointer allows you to type text. The arrow pointer allows you to select a button, a check box, a radio button or an item from a list
  2. After entering text or selecting an item, check box, or radio button do one of the following:
    1. Press Tab to accept the form field change and go to the next form field
    2. Press Shift+Tab to accept the form field change and go to the previous form field
    3. Press Enter (Windows) or Return (Max OS) to accept the form field change and deselect the current form field
  3. Save to your computer
  4. Attach to an email and send to the dental office location where you have an appointment (see: above)