How to get your forms

The forms are completed before your examination begins, and there are two ways to do that. Arrive about fifteen minutes before your appointment and complete the packet at the office, which is usually enough time. Or call the office at (559) 683-4694 and ask about receiving a copy in advance so you can complete it before you arrive.

In either case, bring the items listed further down this page: a photo ID, your dental plan card if you carry benefits, a current list of medications with doses, and your physician's name and number. The office is open Monday through Wednesday from 8:30 am to 5:00 pm and Thursday from 7:30 am to 4:00 pm.

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What the paperwork is for

New patient paperwork is the record of who you are, what dental work you have had, what you take, and how your general health affects treatment. Clinical decisions start from this record, so it should be completed carefully rather than quickly.

It also settles the administrative details before the appointment begins: how to reach you, who is responsible for the account, and confirmation that you have received the Notice of Privacy Practices. Completing this in advance leaves the appointment time for the examination itself.

What you will be asked for

The forms ask for four kinds of information, each collected for a reason. Have the details available before you begin.

Patient and account details
Legal name, date of birth, address, a phone number where you can be reached, and an emergency contact. If someone other than the patient is responsible for the account, that is recorded here as well.
Dental history
When you were last seen, where, and what was done, along with anything that has caused problems before: a tooth that remained sensitive after a filling, a crown that came off more than once, or a difficult extraction. Prior history helps guide current treatment.
Medical history and medications
Conditions, surgeries, allergies, and every medication with its dose. Include supplements, over the counter products, and anything you take only occasionally. If you are not sure whether something is relevant, include it.
Benefit and payment information
Your dental plan card details if you carry benefits, and an acknowledgment of the office financial policy. See costs and payment options.

Why the medical history matters

What you take, and what you have been treated for, affects what is safe to do during dental treatment and how it is done. That is the reason the medical section is as detailed as it is.

Blood thinners change how a site bleeds and how it is managed afterward. Bisphosphonates and some other bone medications can change how the jaw heals after an extraction, sometimes long after the last dose. Diabetes that is not well controlled can change how gums respond to treatment and how quickly they heal. Heart valve history, joint replacements and immune suppression can call for antibiotic coverage or a consultation with your physician first. Many medications reduce saliva, and a dry mouth can raise decay risk.

Record all of it, including the items that seem unrelated to teeth. If you are pregnant, or think you might be, tell the office before any x-rays are taken. Questions about your own medications are best directed to your pharmacist or physician.

Completing the paperwork at the office

The forms can be completed at the front desk before the examination. Doing so requires some extra time before your appointment.

  1. Arrive fifteen minutes early

    That is usually enough time to complete the packet without rushing. Arrive earlier if you take several medications and want time to copy the list accurately.

  2. Bring the source documents

    Bring your medication bottles or a photograph of the labels, your dental plan card, a photo ID, and your physician's name and number. A dose is easier to copy from the label than to recall from memory.

  3. Ask if a question is unclear

    Some of the medical questions use terms that may be unfamiliar. Ask at the front desk rather than leaving a line blank.

  4. Mention any difficulty with the forms

    If handwriting is difficult, small print is a problem, or English is not your first language, mention it when you schedule and ask what assistance is available.

A few situations require an additional step before treatment can begin.

  • Patients under eighteen. A parent or legal guardian must be present at the first visit to complete the history and give consent. A grandparent, a stepparent or a family friend cannot sign in their place without legal authority.
  • Separated or divorced parents. The adult who brings the child must have the authority to consent to treatment, and must be the person taking responsibility for the account. If that arrangement is not clear, call the office before the appointment and ask what is needed.
  • Adults with a legal representative. If someone holds power of attorney or is a conservator, bring the documentation to the first visit so it can be added to the record.
  • Interpreters and companions. You are welcome to bring someone with you, particularly for a treatment discussion. Mention it in advance if you would like them present during the appointment.

Records from your previous dental office

If you have been seen at another office in the last two or three years, call that office and ask that your x-rays and chart be sent here. Under both federal and California law you have a right to copies of your records, and offices generally release them on a signed written request. It can take a week or two, so make the request early.

Recent images can reduce the number of new ones needed and provide a baseline for comparison. A tooth that appears unremarkable today may show meaningful change next to an image from two years ago. If the records do not arrive in time, any images that are needed can be taken at the visit. See what the first visit involves.

After the first visit

Your history is reviewed at each visit, and you will be asked whether anything has changed. A new medication, a new diagnosis, a hospital stay, a pregnancy, a change of dental plan or a change of address should all be recorded before treatment rather than after it.

If something changes between visits and it affects treatment already scheduled, call the office rather than waiting for the appointment. Questions about anything on this page are answered on the common questions page or by phone.