Patient Registration

You may pre-register with our office by filling out our secure online Patient Registration Forms.

After you have completed the form, please make sure to press the SUBMIT button at the bottom of the third page, to automatically send us your information (No need to print these forms).

please note: you will SIGN these documents in-person when you arrive to your appointments.

For assistance, please call our Brentwood office at Brentwood Oral Surgery & Dental Implant Center Phone Number 925-513-0100.

Online Registration Form button

The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.