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Patient Forms

Family Dentist in Hesperia, CA Helps Save Patients' Time During Visits

We know that it can be time-consuming to fill out several patient forms while you’re in the waiting room, especially if it’s time for your appointment. Thankfully, your Hesperia pediatric dentist understands this difficulty and has provided several forms below in order to fill out in the comfort of your own home and take your time so you don’t feel rushed. Contact our office if you have any questions and we look forward to seeing you soon!

Click Here For Our Online Patient Forms

Adult Patient Forms - English

Adult Patient Forms - Spanish

Child Patient Forms

HIPAA Notice

Visit HIPAA.com for more details about Notice of Privacy Practices.


Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Office Locations

  • Hesperia
  • 15550 Main St.
  • Suite B-7
  • Hesperia, California
  • 92345
  • Map & Directions
  • Call: (760) 947-7777
  • Rancho Cucamonga
  • 8283 Grove Avenue
  • Suite 208
  • Rancho Cucamonga, CA
  • 91730
  • Map & Directions
  • Call: (909) 985-9898