Patient Registration & Health History
Registration and insurance information, medical history, treatment consent, and practice policies.
Yucaipa, California
Patient Forms
A little preparation makes your visit feel even more welcoming.
Before Your Visit
We're Glad You're Here
Whether it's your first appointment or you're returning to see our dental family, we're here to make your visit as comfortable and straightforward as possible.
Patient Documents
Download Your Forms
Please review the appropriate packet before your visit. You can view each PDF online or download a copy to print and complete.
Health History & Consent Forms
Patient information, dental and medical history, financial policy, privacy acknowledgement, and authorization forms.
Bring completed forms to your appointment. Please do not email or upload forms containing sensitive personal or medical information through an unsecured channel.
Your First Appointment
What to Bring
To help us get you settled, consider bringing the following to your appointment:
- A photo ID
- Your dental insurance card, if applicable
- A current list of medications
- Any dental records or X-rays you've been asked to bring
Please don't email sensitive medical information or completed health-history forms unless our office has provided an approved secure method.