Patient Forms

Click below to Print Out Registration, Health History, & HIPAA Consent Forms.

Completed forms may be submitted via email or fax….


Fax: 619-434-6288

If your are a Medi-Cal/Denti-Cal patient, please scan a copy or take a picture of your Medi-Cal card

Email: or Fax: (619) 434-6288.

If you’re not sure what your Medi-Cal card looks like, scroll down and look at this flyer.