Patient Forms for Dr. Kihara's Office

For your convenience, we have supplied the following patient forms online for you to print, review and fill out before you head into our office. Please download and complete ALL forms and bring them with you to your first appointment. For any questions on these forms, feel free to call today at (530) 888-1966.

 

New Patient Information Form

Medical History Form

Notice of Privacy Practices

Acknowledgement of Privacy Practices

Financial Arrangements and Dental Insurance

Acknowledgement of Dental Materials

Dental Materials Fact Sheet

Bisphosphonates Signature Form