Best Time to Call: MorningEvening

    Patient Forms


    Our office provides regular office hours Monday through Thursday. 8:00 a.m. to 5:00 p.m. and Friday by appointment. Call (209) 523-KIDS (5437) to schedule an appointment. If you must cancel or reschedule an appointment, we require 72 hours notice.


    ADA COVID Patient Screening Form

    Medical History

    Insurance information form

    Patient information form


    *if unable to access forms online please download them manually

    1.Download Medical History Exam

    2. Download Patient Registration Form



    We accept most major dental insurances. All deductibles and estimated co-payments are due at the time dental treatment is provided. Our estimates are made according to the information given to us by the insurance company and the contracted employer. Any additional charges not covered by insurance will be the obligation of the responsible party. We accept cash, personal checks, as well as VISA, MasterCard, and Discover credit cards. In addition, Care Credit Applications are available in the office.