New Patients: Mobile Number 949-877-3606
Existing Patients: Mobile Number 949-706-7097
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Patient Forms

New and Existing Patient Sign In Portals:

New Patient Form Sign In

Existing Patient Form Sign In

Please print and fill out the forms below so we can expedite your first visit:

Dental History

Health History

Watermark ARES Questionnaire

Patient Registration

General Consent

Notice of Privacy Practices

Office Financial & Disclosure Policies

Patient Rights

Your Responsibilities as a Patient

  • You have the responsibility to provide, to the best of your ability, accurate, honest and complete information about your medical history and current health status.
  • You have the responsibility to report changes in your medical status and provide feedback about your needs and expectations.
  • You have the responsibility to participate in your health care decisions and ask questions if you are uncertain about your dental treatment or plan.
  • You have the responsibility to inquire about your treatment options and acknowledge the benefits and limitations of any treatment that you choose.
  • You have the responsibility for consequences resulting from declining treatment or from not following the agreed upon treatment plan.
  • You have the responsibility to keep your scheduled appointments.
  • You have the responsibility to be available for treatment upon reasonable notice.
  • You have the responsibility to adhere to regular home oral health care recommendations.
  • You have the responsibility to assure that your financial obligations for health care received are fulfilled.