(510) 782-7821
Book Online

Become a Member Now!
(510) 782-7821
Book Online

Become a Member Now!
27206 Calaroga Avenue, Suite 216
Hayward, CA 94545
[email protected]
Contact Info
  • 27206 Calaroga Avenue, Suite 216
    Hayward, CA 94545
    [email protected]
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  • About Us
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    • Meet The Team
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New Patient Forms

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  • New Patient Forms

Please print and fill out each one of the listed forms and bring it to your initial appointment.

New Patient Forms [ENGLISH]

  • Patient Registration
  • Patient History
  • Child Patient History

New Patient Forms [SPANISH]

  • Patient Registration [Inscripcion]
  • Patient History [Antecedentes Paciente]

HIPAA Forms

  • Notice of Privacy Practice
  • Consent for Release of Personal Health Information

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Cosmetic Dentistry of Hayward

Address:
27206 Calaroga Avenue
Suite 216
Hayward, CA 94545
Telephone:
(510) 782-7821
Fax:
(510) 782-2773
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