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Patient Forms

If you are a new patient to our office, please download and complete our new patient forms below and bring them to your first appointment. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Thank you and please contact our office if you have any questions.
  

Patient Registration & Medical History Forms

Guarantor Agreement Form

*For patients who are adults but have another adult listed as Responsible Party.

Pacific Dental Associates Acknowledgement HIPAA Form

*Please read the Notice of Privacy Practices before signing the Acknowledgement form.

Pacific Dental Associates Notice of Privacy Practices


Patients with Insurance

Please bring to your first appointment your insurance information (insurance card, group number, insurance ID, and address to mail the claims).

For patients who are covered under someone else's insurance, please also have the insured complete our Guarantor Agreement form above.


Frequently Asked Questions

Click here to view some of the most frequently asked questions patients have about dentistry and oral health issues.

 

 

 

Dear Doctor is a quarterly dental magazine written exclusively by dental healthcare professionals. We at Pacific Dental Associates believe that keeping you, our patients well informed is key to our success and to your long term oral health. Search by keyword or browse by each magazine issue and let us know if you have questions; we will be glad to assist you. Click here to visit our Dear Doctor page.

Smile Gallery

Click here to visit our online smile gallery with examples of various procedures.