You may preregister with our office by filling out our Patient Registration Form. After you have completed the form, please make sure to bring a printed copy to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
- Patient Registration: Health History Form [PDF Download]
- Patient Information: “The Facts About Fillings” and Other Dental Materials [PDF Download]
- Office Policy [PDF Download]
- Notice of Privacy Practices [PDF Download]
Call Newark Office Phone Number (510) 656-4400 with any questions about completing our forms.