Patient Forms

Please take a minute to  fill out the patient information form before your first appointment by clicking the icon below: 


If you plan to use your dental insurance, please have your insurance card ready.

As part of our new COVID-19 Protocol recommended by the American Dental Association, we will be asking a few screening questions prior to your appointment and the same questions upon check-in. You can expedite this process by filling out part of the form before your check-in appointment. Please click icon below to download and print form to fill out: 

River Oaks
670 River Oaks Pkwy Ste J
San Jose, CA 95134
(408) 894-8140
Tue: 8:00 am - 5:00 pm
Fri: 8:00 am - 5:00 pm
Sat: 8:00 am - 3:00 pm
Pacific Bay
3720 N 1st St Ste C
San Jose, CA 95134
(408) 894-8135
Wed: 8:00 am - 5:00 pm
Thur: 8:00 am - 5:00 pm

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