310.822.3472

New Patient Registration Forms

We recognize that your time is valuable. We will make every attempt to honor your scheduled appointment time. In the interest of saving time, please download the New Patient Registration, Health Questions, Financial Policy, Signed Law Sheet, Facts About Fillings, and Materials forms. Print the forms, fill them in, and fax them to us at 310.306.1062 or simply bring the forms when you come in for your first appointment.

To print our New Patient Registration Form, please click on the link above. You will need Acrobat Reader, which is a free software program that is available by clicking the Get Adobe Reader button below.