Patient Forms

When you visit our office, you will be warmly greeted by our staff and made to feel at home. Dr. Shin will meet with you personally and begin the new patient process. His goal is to better understand your primary concerns and needs. Dr. Shin will write a thorough diagnosis and recommendations to address your dental needs and desires. Your dental experience will be contoured and unique, just like you and your smile!

Please download our patient forms prior to your scheduled appointment. Complete and bring the forms to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to addressing and caring for your dental needs.

First Dental Visit Forms:

Health History

Insurance Information

Financial Agreement

Missed Appointment Policy

Acknowledgment of Receipt of Notice of Privacy 

Forms for Patients Reference:

HIPAA Privacy Act - English

HIPAA Privacy Act - Spanish

Dental Materials Advantages & Disadvantages - English

Dental Materials Advantages & Disadvantages - Spanish

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.