How to get your forms

There are two easy ways to get the forms done before your examination. Come about fifteen minutes ahead of your appointment and fill the packet in here, which is usually plenty of time. Or give us a call at (559) 683-4694 and ask about getting a copy in advance so you can do it at home.

Either way, bring the things 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. We're 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

The paperwork is how we get to know you before we ever look at a tooth: who you are, what dental work you've had, what you take, and how your general health affects treatment. Everything we plan starts from what you tell us here, so it's worth taking your time over it.

It also takes care of the practical side: how to reach you, who is looking after the account, and letting us know you have received our Notice of Privacy Practices. Having those settled ahead of time keeps check-in quick.

What the forms ask for

The forms cover four things, and there's a reason for each of them. It helps to have these details with you before you start.

Patient and account details
Your legal name, date of birth, address, a phone number where we can reach you, and an emergency contact. If someone other than you is looking after the account, we'll note that here too.
Dental history
When you were last seen, where, and what was done, along with anything that has given you trouble before: a tooth that stayed sensitive after a filling, a crown that came off more than once, or an extraction that gave you a rough few days. Knowing that history helps us plan better care for you now.
Medical history and medications
Conditions, surgeries, allergies, and every medication with its dose. Please include supplements, anything over the counter, and anything you take only now and then. If you're not sure whether something matters, put it down anyway.
Benefit and payment information
Your dental plan card details if you carry benefits, and an acknowledgment of our financial policy. See costs and payment options.

Why the medical history matters

What you take, and what you have been treated for, changes what is safe to do in the chair and how we do it. That is the only reason the medical section runs as long as it does.

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 word with your physician first. Many medications reduce saliva, and a dry mouth can raise decay risk.

Please write it all down, even the parts that seem to have nothing to do with teeth. If you're pregnant, or think you might be, tell us before we take any x-rays. For questions about your own medications, your pharmacist or physician is the right person to ask.

Filling the forms in at the office

You're very welcome to fill the forms in at the front desk. It takes a few extra minutes before your appointment, and here's how to make them easy.

  1. Come fifteen minutes early

    That's usually plenty of time to work through the packet without feeling rushed. Come a little earlier if you take several medications and want time to copy the list accurately.

  2. Bring what you need to copy from

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

  3. Ask us if anything is unclear

    Some of the medical questions use terms that aren't exactly everyday language. Please ask at the front desk rather than leaving a line blank. We're happy to explain any of it.

  4. Tell us if the forms are hard going

    If handwriting is difficult, if small print is a problem, or if English isn't your first language, let us know when you schedule and we'll help you through them.

A few situations need one extra step before we can start treatment.

  • Patients under eighteen. A parent or legal guardian needs to be with them at the first visit to complete the history and give consent. A grandparent, a stepparent or a family friend can't sign in their place without legal authority.
  • Separated or divorced parents. The adult who brings the child needs the authority to consent to treatment, and needs to be the person taking responsibility for the account. If that arrangement isn't clear, give us a call before the appointment and we can talk it through.
  • Adults with a legal representative. If someone holds power of attorney or is a conservator, bring the documentation to the first visit so we can add it to the record.
  • Interpreters and companions. You're very welcome to bring someone with you, especially for a treatment discussion. Let us know in advance if you'd like them in the room with you.

Records from your previous dental office

If you've been seen at another office in the last two or three years, give them a call and ask for your x-rays and chart to 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 it's worth asking early.

Recent images can mean fewer new ones, and they give us something to compare against. A tooth that looks unremarkable today can tell a different story next to an image from two years ago. If the records don't arrive in time, we can take whatever we need at the visit. See what the first visit involves.

After the first visit

We'll go over your history at each visit and ask 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 are all worth telling us about before treatment rather than after.

If something changes between visits and it affects treatment we've already scheduled, please give us a call rather than waiting for the appointment. Anything this page doesn't cover, you'll find on the common questions page, and you're always welcome to ask us when you call.