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(925) 362-8180
AVALONDENTAL

Patient forms

Fill this in at home, not in our reception.

About ten minutes on your own sofa, at whatever time suits you. It means your first appointment starts with a conversation rather than a clipboard.

Before you start

Four things worth having next to you.

None of it is essential — you can save and come back — but having it to hand makes this a ten-minute job rather than a twenty-minute one.

  • Your insurance card, or a photo of the front and back
  • A list of any medications you take, including doses
  • Your medical history — conditions, allergies, past surgeries
  • The name of your previous dentist, if you'd like us to request records

Rather do it here? That’s completely fine — arrive fifteen minutes early and we’ll give you a tablet. Nobody is going to mind.

A note on where this goes

The forms open on a secure service we use for patient paperwork, which is why the web address changes when you click through. It connects directly to our records system, so what you enter is waiting for us when you arrive rather than being retyped by someone at the front desk.

We ask for medical history because it genuinely changes treatment — medications that affect bleeding or bone healing, conditions that change how we use anesthetic, allergies. It is not administrative box-ticking, and if any of it seems irrelevant, ask us and we’ll tell you why we need it.

How we handle your information is set out on our privacy page.

In pain and trying to be seen today? Skip the forms and call us — we’ll take what we need over the phone and sort the paperwork afterwards.