Forms

We value your time! To minimize your wait, please print out these forms at home and bring them completed on your first visit.

• Patient Information Form
  
  
• HIPPA Form
  
  
• Dental Services Consent Form
  
  
• Insurance Information Form

If you’re transferring to our office, we’ll need a copy of your most recent x-rays and/or periodontal probe chart (if applicable). We’d appreciate it if you could request these from your previous dentist prior to your visit. Digital x-rays in jpg format would be ideal. These can be emailed to placentiafamilydentistry@yahoo.com

Placentia Family Dentistry 

Dr. Barbara Tran DDS

Call Us:  714-528-0089