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New Patient Forms

San Francisco, Berkeley, Piedmont, & Oakland, California

If you are a new patient please fill out the forms below:

Click here to securely fill out a complete set of forms online or you may download and print (or download, update the fields on your computer, resave and email us) these PDF forms.

If you wish to download each form separately please use the links below.

Health and Dental History
Please provide us with a brief history of your health and dentistry.
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Patient Information
This form provides us with important contact and insurance information. Filling this form out before you arrive can save you time during your first visit with us.
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How Can We Help You
Our office is very unique and unlike any dental office you have ever been to. Your upcoming visit is an important first step toward getting the dentistry you seek.
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For Your Comfort
Your comfort is our priority. We provide a variety of services to assure that you are comfortable at all times. Please select from the following menu if you prefer any of these options.
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Joshua Bernstein, D.D.S - San Francisco Cosmetic Dentist