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Patient Forms

 
(408) 258-4040

The first visit to our office is designed to get you better acquainted with all we offer as well as introduce you to Dr. Haake and our caring staff. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you 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 assisting you with all your dental needs.

New Patient Form

Health History Form

HIPAA Privacy

HIPAA Consent Form  

 

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.

 

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