Patient Forms

The first visit to our office is designed to get you better acquainted with all we offer as well as introduce you to Dr. Nguyen and our caring staff. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs. Please contact us if you have any problems downloading these forms. 

New Patient Registration Packet


Patient Registration and Treatment Forms (New Patients - 1 Page) 

Dental and Medical History, and Authorization Forms (New Page- 1 Page)

Confidential Health History Forms(New Patients-2 pages)

Patient Consent for Use & Disclosure of Health Information (New Patients -2 Pages)

Notice of Privacy Practices (New Patients - 2 Pages)

The Dental Board of California (1 Page)

Comparisons of InDirect Restorative Dental Materials (2 Pages) + Glossary (1 Page)


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.