New!! Patient Intake Forms Are Now Available For Online Submission!
Please take advantage of this new safe and secure way to input your forms directly into our practice management software! Click on the secure hyperlink below:
New patient? We would prefer you to submit your intake forms online using the "Hello Patient Portal" above. However, If you do not wish to complete the online forms, please download and fill out the following forms before you come in for your first appointment.
Patient Information Intake Form
This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.
Patient Medical and Dental History Forms
This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.
Privacy Notice
Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.
The form is saved in Microsoft Word format. If you don't have MS Office/Word, you can go here to download the "MS Word Viewer" for free:
http://www.microsoft.com/en-us/download/details.aspx?id=4
Or, if you don't have Microsoft Office and would like a completely free alternative, open source productivity package, try Apache OpenOffice here:
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The Facts About Fillings
Please review this informative brochure published by the Dental Board of California. This is required to be given to any patient receiving restorative care.
Call us at: (951) 303-2818
The Smile Suite at Towne Square
32605 Temecula Parkway, Suite 213
Temecula, CA 92592
Use our contact form to get in touch.
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Mon.-Thurs. 11:00 A.M. to 6:00 P.M. Fri 11 A.M.-5 P.M. Sat. 11 A.M. - 2 P.M. (by appointment only)
Outside our regular business hours, please note our emergency care information.
What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.