Patient Forms
Please use the button below to take you to a secure site where you can enter all the necessary information prior to the arrival for your appointment. This will greatly speed up the registration process for your next visit. Thank you and please call our office if you have any questions at all.
If you are a New Patient please fill out both form 1 (new patient registration) and form 2 (medical history).
If you are an Existing Patient please fill out and updated medical history form only.
Online 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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Testimonials
"Dr Tjans the best dentist ever, even though had issues with past staff last year; still chose to stay because he’s an excellent dentist. My family has had Dr Tjans for years. I’ve always been covered 100% for just about everything but recently told by office staff, she sounded frustrated with me, said what delta covers is lower; therefore I’m responsible to pay out of pocket and that’s never been an issue. Ive been with this dentist for years and happy with Dr Tjan. I even checked if had options during open enrollment but I don’t; now I’m really concerned and don’t really want to change dentists. 😕"