Patient Forms

Use the links below to our new patient forms.  Please complete these forms and bring them with you to your first visit

Notice of Privacy Practices

New Patient Registration

Health History Form

Dental History Form

Dental Materials Fact Sheet

Office Policy 

If you have any questions, please call the office at (213) 625-7141.


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Our Office

Los Angeles

420 East Third Street (Suite 1008),
Los Angeles, California 90013
(213) 625-7141
(213) 625-7167
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We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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