Forms

Prior to your first visit we ask that you complete the following forms:

• Patient Registration Form (Patient Registration PDF)
• Orthodontic Health Questionnaire (Health History PDF)
• TMJ Questionnaire (if applicable) (TMJ Questionnaire PDF)
• HIPAA (HIPAA PDF)

Please bring the completed forms along with your insurance card and information with you to your appointment.


Please call our office for a consultation: (760) 758-0630

221 Main St., Ste. 100
Vista, CA 92084

ph760.758.0630

fax760.758.5466

Monday - Thursday

8:00 am - 5:00 pm