Patient Forms

 

 

 

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download.

 

 adult health history.pdf

child health history.pdf

implant consent form.pdf

periodontal treatment consent form.pdf

root canal consent form.pdf

crown consent form.pdf

dentures consent form.pdf

extraction consent form.pdf

facts about fillings.pdf

HIPAA form.pdf

 

Where to Find Us

Call: 559-225-4540

4747 North 1st Street
Fresno, CA 93726

Email: rjbdental@gmail.com

4747 North 1st Street|
Fresno, CA 93726

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