New Patient Paperwork

If you are a new patient to our Tempe dental office, the attached file contains our new patient forms that you can download, print and fill out prior to your scheduled appointment in our Tempe dental office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them upon your arrival.  Thank you and please contact our Tempe Smile Design if you have any questions.  

New Patient Registration Forms


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.


$89 New Patient Special

  • Includes complete exam (including oral cancer check), necessary x-rays, and healthy cleaning (in the abscence of periodontal disease)
  • Insurance will be billed if applicable

Limited Time Offer.


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.

Monday - Friday: 8:15 - 5:00
Saturday & Sunday: CLOSED


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