family & cosmetic dentistry
Patient Forms!

To save you time we have placed our new patient forms on-line. The forms are in Adobe Acrobat format and will require that Adobe Acrobat Reader be installed on your computer. Download Acrobat Reader.

Clicking the link to the forms below will cause it to be loaded into your web browser or a prompt to save the form will appear. After the forms are loaded or you have saved them, you may print them out, write in your information, and bring them with you to your appointment. You may also fax them to our office at any time prior to your appointment. Our fax number is (408) 923-7389.

New Patient Forms

If you experience any problems, or have any questions about the forms, our staff will gladly assist you. Please call our office at
(408) 923-5511, or send us an e-mail through our Contact Us page.

© 2004
by Grant Shimizu, DDS, Inc
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