In order to maximize your time at your first visit, we ask that you please print each form out and bring the completed forms with you to your appointment. The Notice of Privacy Practices and Dental Materials Facts Sheet are for your information and do not need to be returned to us. We will need all other forms.

If you have any problem getting these files to print properly, please call our office and we will gladly send or fax them to you.

• Guest Registration

• Health History

• Financial Information

• Consent to Perform Dentistry


To Read Only:

• Dental Material Fact Sheet

• HIPPA Notice of Privacy

Feel free to call 408.354.5600 or e-mail us with any questions.

New Guest Forms • Affordable Financing • New Guest Special • Contact Us



Dental Implants • Cosmetic Dentistry • TMJ Treatment • Conscious sedation
Invisalign • Laser • Neuromuscular Full Mouth Rehabilitation

Nancy Nehawandian, DDS • 250 Blossom Hill Road, Suite 100 • Los Gatos, CA 95032 • 408-354-5600

Comprehensive Aesthetic Dentistry for the San Jose Bay Area
including Campbell, Palo Alto, Los Altos, Santa Clara and all the surrounding cities.

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