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Patient Forms

Appointments

Patients are seen on an appointment basis, and we reserve time specifically with you and the doctor or hygienist. We ask that you complete an online appointment request or call (714) 542-9606 in advance so that we may reserve an appointment time for you.

If you are a new patient to our office, the link below contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing forms, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please contact our office if you have any questions at all. Click on links below to download forms.

PATIENT FORMS 

    Registration Form

    Medical History Form

    Dental History Form

    HIPPA Form

    Signature On File Form

    Consent To Dental Treatment Form

    COVID-19 Pandemic 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.
Kent T. Ochiai DDS, PhD
Alexander C. Gavrila, DDS
Prosthodontic, Restorative and Implant Dentistry

Santa Ana, California Prosthodontists Dr. Kent Ochiai and Dr. Alex Gavrila are dedicated to prosthodontics from prevention care to restorations and implant dentistry. We provide a variety of cosmetic

2024

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Our Office

17501 Irvine Blvd, Suite 201Tustin, CA 92780Get Directions7145429606

2024

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and esthetic treatments such as dental implants, porcelain veneers, dentures, teeth whitening & more.