Office FAX: (949) 501-7077
Office E-mail: firstname.lastname@example.org
PATIENT FORMS: PLEASE COMPLETE ALL LISTED FORMS BELOW PRIOR TO YOUR UPCOMING APPOINTMENT. Please arrive 30 minutes early if you plan to complete the forms at our office.
PATIENTS WITH DENTAL INSURANCE: If you wish for us to bill your insurance company and have your benefits payable directly to our office, please provide us your dental insurance information (card) to verify your eligibility and benefit provisions before your first scheduled appointment. Otherwise, you will be responsible to make full payment for services rendered and we will submit the insurance claim on your behalf to have the benefit payments sent directly to you.
MAP & DIRECTIONS TO OUR OFFICE: Select the “Location” button (to the left) for a map on the Yahoo map system as well as written directions from all areas of Orange County.