Name: Serramonte Dental Group
Address: 1101 El Camino Real, San Bruno, CA, 94066
Telephone: 650-756-0938

General Patient Forms

> Patient Forms > General Patient Forms

General Forms

To continue making your dental experience a pleasant one, we have conveniently provided our dental forms below so that you can fill them out in the comfort of your home, and bring them into the office with you or submit them directly online.

If you are the parent or guardian filling out this form for your minor child YOU MUST be present for the first appointment for authorization and ID verification. No exceptions.

General Dentistry Forms
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HIPAA Notice of Privacy and Consent
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Authorization for the Release of Dental Records

If you are 18 years or older and your parents are financially responsible for you, please fill out and sign this form so that we can have your permission to talk to a parent about your treatment and associated costs.

New Patient Information
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Health History
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COVID-19 Screening Form

Get The Care You Deserve!

Serramonte Dental Group would love to meet you and your family and provide you with the dental care you deserve! Our office is conveniently accessible to those living near San Bruno.

Request An Appointment Online

Or call us today at: 650-756-0938

Hablamos español!