If you are a new patient to our Petaluma dental office, the patient registration packet available below will need to filled out when you arrive for your first appointment in our dental office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please call our dental office if you have any questions or need any assistance.
New Patient Forms - English
New Patient Forms - Spanish
Patient Screening Form
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
We’re pleased to offer our patients CareCredit, North America’s leader in patient payment plans. CareCredit lets you begin your treatment immediately – then pay for it over time with low monthly payments that fit easily into your monthly budget.
Like a credit card, but better
CareCredit works like a credit card, but is exclusive for healthcare services. With no up-front costs, no pre-payment penalties, and no annual fees, CareCredit lets you pay over time and frees up cash and credit cards for the other things you want or need. CareCredit offers low monthly payment plans for healthcare procedures not commonly covered by insurance, including dental treatment. Plus, you can use your card again and again to pay for additional treatment for yourself or family members in any CareCredit practice.
Low minimum monthly payments
No-interest financing if paid within 12 months (Additional plans may be available)
No up-front costs, pre-payment penalties or annual fees
Learn more by visiting CareCredit.com or contacting our office. It only takes a few minutes to apply for CareCredit and you may receive an online decision in seconds! For more information or to apply now, just click on the link below.