"Serving the Alta Loma & Rancho Cucamonga community since 1993"

Patient Forms

Our dental office has been in the same location since 1993, serving patients in Rancho Cucamonga, Alta Loma, Fontana, Upland and other areas. Forms for our new patients or for updating medical history can be printed from the link below. These forms can be filled in using your computer or printed out and filled in by hand.


We take the fear out of dentistry

As the “Gentle Dentist” of Rancho Cucamonga, our dental services reach out to Upland, Ontario, Fontana, Rancho Cucamonga and other areas:

Pediatric (Children) Dentistry | Cosmetic Dentistry | Sedation Dentistry | Laser Dentistry | Implant Dentistry | Orthodontics | Porcelain Crowns (Caps) | Onlays | Cosmetic Porcelain Veneers | Lumineers | Teeth Whitening | Composite (white) Fillings | Amalgam Fillings | Root Canal Therapy (RCT) | Partial Dentures | Full Dentures | Cosmetic Porcelain Bridges | Sleep Apnea Treatment | Dental Implants | Periodontal Treatment | Teeth Extractions | Oral Hygiene

Dentist Fontana| Dentist Ontario | Dentist Upland