NEW PATIENTS

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Please click on the desired PDF form, save it, click the right button to save to your computer.
Huntington Beach office: (714) 374-8800
We want to hear from you. Send a fax to (714) 374-1399

Adult Welcome forms:
Adult Welcome form 1
Adult Welcome form 2

Child Welcome forms:
Child Welcome form 1
Child Welcome form 2

Patient Consent form:
Patient Consent form (front)
Patient Consent form (back)

Adult Welcome forms:
Spanish Adult Welcome form 1
Spanish Adult Welcome form 2

Child Welcome forms:
Spanish Child Welcome form 1
Spanish Child Welcome form 2

Orthodontic History form
Orthodontic History form

Financial form
Financial form

Privacy form
Privacy Practice Act

 

For New Patient consultations, please call our office, fax or email your insurance information at least one business day before your visit, so that we can estimate your out-of-pocket cost of treatment, and bring your insurance information to the office visit.

Huntington Beach office: (714) 374-8800
We want to hear from you. Send a fax to (714) 374-1399