Patient information

Patient information is a very important step in getting to know our patients. It also provides us with the valuable information we need to bill your insurance for you, this we do as a courtesy to you.

New Patient Forms

Please take a moment to print and fill out your patient registration and health history. Be sure to bring it with you on your first visit
Below are the forms for you review and fill out

Medical History

Patient Registration Form

Please take a moment to review the following for

Financial Agreement / Assignement of Benefits

HIPPA Regulations and Privacy Notice

Questions?

If you have any questions at all, please feel free to call or email us. We look forward to seeing you!

Randall W. Smith, DDS
The Proper 32
2003 S Coast Highway
Oceanside Ca 92054
760-758-8506