New Patient Forms
We are delighted to welcome you as a new patient to our practice.
If you need to schedule an appointment, you can do so by calling (714) 546-3000 for the Costa Mesa office.
We are determined to make your first visit comfortable and only the beginning of an enduring relationship. It will be necessary to complete the forms to the right, above. Please make sure you fill in all yellow areas, and N/A if not applicable. Also please answer all questions on the Health History questionnaire.
FULL DENTAL SERVICES
We provide a full scope of dental procedures, treatments and services. This includes composite fillings (white), deep cleanings, root canals, crown and bridges, veneers, extractions including wisdom teeth, dentures, implants and invisible braces.
NO UP-SELL HERE
We will never attempt to sell or pressure you into any expensive and/or unnecessary treatments or procedures. Rather, together with you, we will collaborate to determine a treatment plan that is best suited for your needs.
YOUR TIME IS VALUABLE
We run on time! That’s right- your time is valuable and we are committed to keeping the time spent in the waiting room to the absolute minimum.
HATE FINDING PARKING?
We do too. Don’t worry, We have plenty of easily accessible (1st floor) parking for your convenience.
NO INSURANCE, NO PROBLEM
Most PPO insurances are accepted. In-house insurance available (Ask about our Dental Health Club Plan).
Dental Health Club Plan (See our Web Page that gives full details)
For those with no dental insurance coverage, we offer an affordable and hassle free in house dental club plan. Our Dental Health Club Plan is the best alternative to dental insurance. There is an annual premium without any waiting periods. Our dental plan is simple and easy to use. So whether you are a student, businessman, an employee or a senior citizen, we have an affordable plan for you and your family. With no hidden charges, our complication free dental plan will suit your pocket. So why wait! Come in & Sign up 🙂
CareCredit is a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance or to bridge situations when desired care exceeds insurance coverage. CareCredit is offered primarily for healthcare cost.
Founded in 1987, CareCredit was initially offered to doctors to help their patients pay for new dental implant technology. Continued advancements in technology, and procedures that are often not covered or fully covered by insurance, have created new choices for care, increasing the demand for financing options.
CareCredit is a simple way to consolidate and manage certain out-of-pocket healthcare expenses, because it is a credit card that can be used repeatedly and for any family member. CareCredit offers two basic payment options to meet an individual’s financial needs