You may download the following forms for completion prior to your visit to save time. You can bring them with you to the first appointment. For fastest service, FAX to (408) 249-5123 or mail to Dentistry for Children of Santa Clara, 2790 Newhall Street, Santa Clara, CA 95050 so we can pre-register you. Please write legibly.
This information allows us to establish your account, review relevant medical history, and document your consent for treatment on your child.
This consent extends to associate, Dr. Jeff Alcaide.
This form is necessary only if you should wish to allow another responsible adult to bring your child to a dental visit and make informed decisions for diagnosis or treatment.

2790 Newhall Street, Santa Clara, CA 95070 - (408) 249-5121
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