Patient Registration Forms


Please download, print, and fill-out our Patient Registration Forms. After you have completed them, please make sure to bring them on your first visit to our office. We look forward to helping you achieve a healthy and beautiful smile!

Health History Form .pdf ( 2 Pages)

Cancellation and Appointment Reminder Preferences.pdf

SCD Privacy Practices Notice.pdf ( 2 Pages)

Technical Note:

You need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe’s web site if it is not already installed on your system.


19366 Soledad Canyon Rd, Santa Clarita, CA 91351

Office Hours

MON - FRI 9:00 am - 6:00 pm

SAT 9:00 am - 4:00 pm

SUN Closed

Get in Touch


Phone: (661) 252-8888

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