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

200 Civic Center Drive, Ste. 100
Vista, CA 92084

ph760.758.0630

fax760.758.7604

Monday - Thursday

8:00 am - 5:00 pm