Patient Forms

We have made it very easy for you to securely fill out forms online in the comfort of your own home or office. This will allow you to be seen in a timely manner at our office if this is done in advance.

We are an environmentally-friendly dental office that does not have physical charts or paper. We maintain a technologically-advanced paperless electronic dental chart.

Please fill out the form below to completion and email it to

Medical Dental History

If you have ANY questions, please call us at 818-538-5718 or email

Reference Materials Required by Law For Patients

1. dental materials facts sheet
2. HIPPA privacy form