For New Patients

New Patient Forms

Please download and complete form 1-3 below and fax them back to 949/362-7540.

  1. Patient Information & Medical History
  2. Patient Evaluation
  3. Cancellation Policy
  4. Patient Acknowledgement of Receipt of Notice of Privacy Practices
  5. Dental Materials Fact Sheet
  6. Consent for Zoom! Tooth Whitening
  7. Cracked-Tooth Syndrome

To all of our new patients, we practice comprehensive dentistry and reserve an hour and a half just for you for your first dental visit and professional dental cleaning with us. If for any reason you are unable to keep your appointment, please inform us 48 hours in advance.

Your first appointment will include a thorough evaluation including:

  • Digital X-rays and photos
  • Detailed examination of your teeth, soft tissue and supporting structures
  • Assessment of your bite and jaw alignment
  • Oral cancer screening
  • Periodontal exam (to screen for gum disease)

Then together we will discuss any necessary dental treatment and recommendations considering your expectations, concerns, and goals. We will work with you to get the results you desire.

If you have any questions feel free to call our dental office in Aliso Viejo