Patient Forms

To expedite the process of filling out the necessary forms prior to your visit with Dr. Patterson, please click on the forms links below. If you need to install the FREE Adobe Reader program, please select the Adobe Install Icon and follow the directions for installation to your computer. The patient forms will open in the Adobe Reader program ready to print.

New Patient Health Questionnaire

• New Patient Health Information Questionnaire [3 pages]

All New Patient Forms (California State Requirement)

• Forms given at time of office visit

• Website for more information about Dental Materials Fact Sheet:
  www.dbc.ca.gov/formspubs/dmfs.htm

Informed Consent Forms for Procedures

• Periodontal Treatment (non-surgical) [2 pages]

• Extraction [2 pages]

• Crowns & Veneers [2 pages]

• Root Canal Treatment [2 pages]

To find out more about financing options, procedures, and how Dr. Patterson can help you find your perfect smile contact us today.