Patient Forms

Patient Forms: Please download, print & complete

Please take a few minutes to print and fill out this form before your first visit. For Adult/Child 

New Patient Form.pdf

Please take this form to your general dentist each time you have a check up exam. Your dentist will sign it and bring back to our office so we can update your health record.

Cavity Clearance Form.pdf  



This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

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Care Orthodontics
88 Tully Rd., Ste. 113 San Jose, CA 95111.
Phone: (408) 971-2885
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