Be ready for your first visit by following these steps:

  1. Please bring:
    • Referral Slip
    • Recent Pano or Xray (Taken within a year) –you can request these from your dentist)
    • Dental Insurance Card
      • Medical Insurance Card (if you have dental insurance ONLY)

2. Make sure to submit your Patient Registration Forms via our Secure Online System:

Click HERE for the Patient Registration Form

After you have completed the form, please press the Complete and Send button at the bottom to send us your information. On your first visit, we will have your completed form ready to go. We will simply need a couple more in-person signatures!

The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

As we use electronic medical records, please do not print forms. If you are unable to submit your registration online, arrive 30 minutes early to your appointment where we will have you complete your forms.

Click HERE for HIPAA Notice of Privacy Practices

This form, Notice of Privacy Practices, presents the information that federal law requires us to give our patients regarding our privacy practices.

 

Click HERE Patient Records Request

This Records Request form may be submitted to request copies of your records at our office. Please specify which records you are requesting and where the records should be sent. Please provide a daytime phone number so we may confirm your request. Allow at least 5 days for records request to be processed.

 

Click HERE for Pre Operative Instructions

 

Click HERE for Post Operative Instructions

 

If you have any questions about which forms you need or help filling them out
please call any of our three locations:

Escondido: (760) 432-8888

Rancho Bernardo: (858) 673-0737

Encinitas: (760) 436-7660