NEW PATIENT FORMS

We are pleased that you chose Creekside Dental Care office of Dr Bal to serve your dental needs. Your personal health information is protected by 256 bit SSL encryption.

IMPORTANT TIPS:

  1. Please have your list of medications before you start filling any forms.
  2. Please be prepared to finish all forms in one go, because there is no way to save progress.
    • While Med History has a lot of required fields, three forms are simple read and sign.
    • If you have sent us your insurance information you can skip that portion.
    • Dental Survey is at your option and has almost no required fields.
  3. Please Scroll Down to "SIGN" which can be done by finger on a smart phone, tablet or by mouse on a desktop/Laptop.
  4. When done filling all SIX forms, please click "SUBMIT" to finalize.
  5. PLEASE TEXT US WHEN YOU ARE DONE at 916-723-4777 (Save this number in your phone as Creekside Dental Team)