Family, Cosmetic & Implant Dentistry

(323) 581-0754

Forms

Due to the recent COVID-19 pandemic and for your added safety and convenience, all our patient forms are available online. You can fill out all of our forms on a computer or your mobile device and sign them so we will have them prior to your visit. We’re happy to help answer any questions you may have. At your appointment, please bring your ID and insurance card to expedite insurance processing. 

All your information is safe and goes straight into our secure patient software. Please don’t forget to hit the “submit” button at the end of each form.

Please read our Notice of Privacy Practice bellow and sign our HIPPA form bellow.

COVID-19 Screening

Due to the COVID-19 pandemic and CDC recommendation for safety and well being of all our staff and other patients we prescreen all patients prior to their visit to our office. Please take a few moment to fill out the prescreening form to ensure the safety of not only yourself but also expedite your visit to our office.

 

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8536 Long Beach Blvd, Suite B

South Gate, CA 90280

323-581-0754