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New Patient Forms

The following forms are required for new patients at Dr. K's office.

You may print and fill out the following forms in order to have a quick, expedited first visit at Dr. K's office.

Click the download button to open the forms in a printable view

Services

Children

• Appointment Policy
• Medical History
• Bllings Facts
• Receipt of Notice
• Responsibility Party

Adults

• Appointment Policy
• Billings Facts
• Receipt of Notice
• Patient Information and Medical History

Note: In order to view these forms, it's recommended you have Adobe Reader installed on your computer. Click here to download the latest version.

 
 
 
 
 

 
 
Dr. Irina, a San Jose dentist, would like you to learn as much as you can about oral health and proper oral hygiene. You will never dread coming to your dentist in San Jose again because Dr. K's Dental Group teaches you good dental habits, that if followed, will eliminate your fear of the dentist. Learn More >>>

 


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We Proudly Serve Patients in the
Greater Bay Area, Including:

• San Jose 95130, 95117, 95129 • West San Jose
• Sunnyvale • Campbell 95008 • Palo Alto
• Mountain View • Los Gatos • Saratoga 95070
• Evergreen 95148 • Berryessa • Milpitas • Fremont
• Newark • Cupertino 95014 • Monte Sereno
• Santa Clara 95051, 95050

 

 

 
 
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