Forms
Prior to your first visit we ask that you complete the following forms:
• Patient Registration Form PATIENT INFORMATION FORM.pdf
• Orthodontic Health Questionnaire ORTHODONTIC PATIENT HEALTH QUESTIONNAIRE.pdf
• TMJ Questionnaire (if applicable) TMJ QUESTIONNAIRE.pdf
• HIPAA PRIVACY CONSENT FORM-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
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200 Civic Center Drive, Ste. 100
Vista, CA 92084
ph760.758.0630
fax760.758.7604
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Monday - Thursday
8:00 am - 5:00 pm