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*Note: Adobe Acrobat Reader is required to view and print the following forms. Adobe Acrobat Reader is free to download and is available directly from Adobe.

Please print out the necessary form(s), fill in the required information and bring them with you for your next visit.


New Patient Package (Complete Package: All the forms below)

  -Patient Registration
  -Medical History
  -Dental History
  -Patient Acknowledgement Form

  -Insurance Facts
  -Notice of Privacy
  -Dental Materials Fact Sheet

235 S. Flower Ave. | Brea, California 92821 | Dr. Richardson: 714.990.3672 | Dr. Christensen: 714.256.9332

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