New Patients
Patient Forms
We offer our patient forms online for you to fill out and complete in the comfort of your own home prior to your office visit.
We look forward to treating you!
Patient Forms include:
- New Patient Information
- Patient Health History
- Financial Policy Agreement
- Notice of Privacy Practices
- Acknowledgement of Receipt of Notice of Privacy Practices
All forms are PDF files. Please download to print and bring with you to your appointment.
Your privacy is important to us.
Any information gathered from the above forms or through any communications is subject to our Patient Privacy Policy.
Any information gathered from the above forms or through any communications is subject to our Patient Privacy Policy.
Schedule An Appointment With Us Today!
Office
Hours
Monday:
9am - 6pm
Tuesday:
9am - 6pm
Thursday:
9am - 6pm
Friday:
9am - 5pm
5828 Adenmoor Ave. Lakewood, CA 90713
Ph: (562) 867-1753
Email: jamesleedds@lakewooddental.com
2023 © Lakewood Dental . All rights reserved.