Patient Forms

To save yourself some time on the first appointment, you can fill out our patient forms at home. Please download and print our patient forms here. If you have any questions, please feel free to call our office.

 

New Patient Form

pdf Dental Materials Fact Sheet pdf General Consent
pdf Health History (English) pdf Health History (Spanish)
pdf Patient Registration pdf Receipt Acknowledgement
pdf Appointment & Financial Agreement         pdf Secondary Insurance
       

Informed Consent Forms

pdf Bone Graft pdf Oral Surgery
pdf Orthodontics pdf Scaling & Root Planing
pdf Sedation pdf Cleaning Types
       

Home Care Instructions for Dental Procedures

pdf BONE GRAFT & EXT pdf Implants
pdf RCT, CRN, & TEMPS    

         


     



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Office Location


Manteca Dental Care
521 E. Center St.
Manteca, CA 95336

P. 209-823-9218
F. 209-823-1134