Forms for Our Patients

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

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For Adults

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

Download File

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

Download File

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For Children

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

Download File

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

Download File

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For All Patients

Informed Consent
File Size:	82 kb
File Type:	pdf

Download File

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

Download File

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Covid-19 Forms

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

Download File

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

Download File

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