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What Will Happen At My
First Visit?

Please assist us at the time of your initial visit to the office by providing the following information:

  • Your referral slip and x-rays from your referring dentist.
  • A list of medications you are currently taking (please note that you can fill out your patient registration and medical history form on our website.)
  • If you have dental insurance, please bring any forms or insurance cards with you to the appointment.

Please Note: All patients under 18 must be accompanied by a parent or guardian at the consultation appointment.

Please notify the office if you have a medical condition or concern prior to surgery (e.g. artificial heart valves or joints, heart murmurs requiring pre-medication, severe diabetes, or hypertension).

We will complete an in-depth medical and dental health history and a thorough examination to measure for bone loss, loose teeth, bite, oral cancer screening, TMJ, and other signs of periodontal disease.

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I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.

San Clemente, CA

New Patients:
(949) 264-0562

Current Patients:
(949) 241-6633

Address:
1001 Avenida Pico, Suite K
San Clemente, CA 92673

Office Hours:
Monday: 8:00 AM – 5:00 PM
Tuesday: 8:00 AM – 5:00 PM
Wednesday: 8:00 AM – 5:00 PM
Thursday: 8:00 AM – 5:00 PM
Friday: 8:00 AM – 5:00 PM