Milpitas Dental Center

1101 S. Park Victoria Dr. Milpitas, CA 95035   Call us: 408.263.9343

Patient Registration

For Your Convenience

We have provided our New Patient forms that can be downloaded to the right. They will need to be completed prior to your first visit to our office.

You will also need to read the Notice of Privacy Practices form at our office and sign the Acknowledgment and Access form when you arrive. The Notice of Privacy Practices presents the information that the federal law requires us to give our patients regarding our privacy practices.

To print the forms, you will need Adobe Acrobat Reader. If you do not have Adobe Acrobat, please click here to download it for free to your computer.

Adult Registration Form
Child Registration Form
Office Policies
Patient Consent Form