Patient Forms

Contact Us!

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Office location:
Santa Maria
1670 S. Broadway
Santa Maria, California
Phone: 805-928-6776

San Luis Obispo
1338 Santa Rosa St
San Luis Obispo, California
Phone: 805-543-8440

King City
550 Canal St. Suite A
King City , Ca
Phone: 831-386-0958


If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Patient Forms 

informed consent.pdf

Dental patient record.pdf

Medical History.pdf



Material Fact Sheet.pdf

 Informativa Sobre Materiales Dentales.pdf




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