Here you will find pre-appointment documents that you can fill out online or print and bring with you to your visit.

Notice of Privacy PracticesTHIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATIONDownload PDF
General Dentistry Consent FormAUTHORIZATION OF TREATMENTDownload PDF
Acknowledgement of Receipt of
Privacy Practices
And
Dental Material Facts Sheet
ACKNOWLEDGMENT FORMDownload PDF
Financial ConsentOUR FINANCIAL POLICIESDownload PDF
Health History FormPATIENT INFORMATION FORM
This form can be printed or filled out online and submitted
Download or Edit Online PDF

If you have any questions about Fluoride treatment and you live in or around Cameron Park, give us a call today! We’re located in the Safeway Shopping Center off highway 50.