New Patient Forms

Save time by filling out your necessary forms online. Feel free to give us a call if you have any questions.

What to expect after COVID-19

COVID-19 Screening Form

Patient Registration

Medical History

Insurance and Financial Policies

HIPAA Notice of Privacy Practices

Acknowledgement of Receipt of HIPAA Notice of Privacy Practices

If you have difficulty using our website, please email us or call us at (909) 393-6001

View the ADA Accessibility Statement

Turn on ADA Views

UPDATE: WE ARE NOW OPEN FOR DENTAL SERVICES. YOU CAN SCHEDULE AN APPOINTMENT BY CALLING OUR OFFICE AT (909) 393-6001 OR BY CLICKING THE "SCHEDULE AN APPOINTMENT" BUTTON BELOW.

Please see "What to expect after COVID-19" under the FORMS tab to see our new appointment procedures.