Please Complete the Necessary Forms
Please take a moment to look over our Patient Medical Health History form and Patient privacy act form, as well as our financial policy Complete these forms at your convenience and bring them with you during your first visit. These forms are important to us. The medical heath history form will help us to determine the course of your treatment. We have to know about allergies, sensitivity to anesthetics, medications - basically your whole health picture. As for your records from your previous dentist, we will need you to request a copy of any dental radiographs and bring them to your initial appointment. Please be prepared to have X-rays taken at our office if we do not have recent x-rays from your previous dentist.

We look forward to meeting you at your initial appointment.

Very truly yours,

The office of Soheil Samiei, D.M.D., P.C.