Harbor Dental In Benicia | Benicia CA Dentist
  • About Us
    • Insurance
    • Savings Plan
  • Testimonials
  • New Smiles
  • Our Location
  • Office Hours
    • Appointments
    • Patient Forms
  • Contact Us
  • About Us
    • Insurance
    • Savings Plan
  • Testimonials
  • New Smiles
  • Our Location
  • Office Hours
    • Appointments
    • Patient Forms
  • Contact Us
Search

Forms for Our Patients

Save time in our office and download, print and fill out your forms in advance of your visit. 

For Adults

For new adult patients to Harbor Dental Benicia
File Size: 94 kb
File Type: pdf
Download File

Medical History form is required for all adult new patients
File Size: 91 kb
File Type: pdf
Download File

For Children

For new patients under 18 years old
File Size: 91 kb
File Type: pdf
Download File

Medical History form is required for all new patients under 18
File Size: 109 kb
File Type: pdf
Download File

For All Patients

Informed Consent
File Size: 82 kb
File Type: pdf
Download File

Financial guidelines for all patients or parents/guardians
File Size: 55 kb
File Type: pdf
Download File

Covid-19 Forms

Covid-19 Dental Care Consent
File Size: 51 kb
File Type: pdf
Download File

Dental Patient Covid-19 Screening
File Size: 151 kb
File Type: pdf
Download File

Contact Us
About Dr. Scott Swoboda
Our Location
​
ⓒ All Rights Reserved, 2009-2023
Harbor Dental Benicia for Implants, Invisalign and more
Harbor Dental Benicia
202 Military East, Benicia CA 94510 | (707) 746-1234
  • About Us
    • Insurance
    • Savings Plan
  • Testimonials
  • New Smiles
  • Our Location
  • Office Hours
    • Appointments
    • Patient Forms
  • Contact Us