Please call our office at (510) 524-4633 to schedule your first appointment. Prior to your visit, please print and fill out this new patient form. You may bring the filled forms to our office or email them directly to us at kidsteethdoctor@gmail.com.

*To Email: Download the PDF file onto your computer and fill out the fields directly on the PDF using Adobe Acrobat. If you don't have Adobe Acrobat, you can download it here. Save the document and attach it to an email addressed to kidsteethdoctor@gmail.com.