Download Our New Patient Forms
Welcome to El Segundo Modern Dentistry & Orthodontics! We are happy you have decided to become a patient with us.
- (424) 277-2671
- 310 E. Grand Ave, Suite 102
- El Segundo, CA 90245
- Hablamos Español
Welcome to El Segundo Modern Dentistry & Orthodontics! We are happy you have decided to become a patient with us.
Our dental practice is based on a commitment to safety and quality oral healthcare. As part of this commitment, we take a thorough medical history of our patients prior to conducting any sort of dental or orthodontic treatment. This helps us to ensure that the treatments we provide will be safe for you and your children.
For this reason, we have patient forms that we request that you fill out prior to seeing us. When you are a new patient, these forms will be a couple of pages. The forms might ask some questions that you may wonder, what does this have to do with dentistry? But knowing some of your past medical history can help us tailor our dental and orthodontic treatments to you, as well as take necessary precautions when we are doing certain procedures.
We need to know what medicines you are taking, including over the counter supplements, because this helps us ensure that we’re not going to cause any unforeseen side effects when we use sedation with your dental treatment.
Additionally, if we are doing something such as an extraction, and you are on blood thinners, this could potentially cause bleeding problems. Therefore, it is especially important to let us know if you are taking a prescribed blood thinner. For certain oral health surgeries and procedures, we may need you to take a break from the blood thinner with the approval of your primary care physician or cardiologist.
Additionally, some of our patients who had past heart surgeries may be recommended to take antibiotics for deep teeth cleanings and other periodontal processes that might stir up the bacteria that’s in the mouth.
Yes, El Segundo Modern Dentistry & Orthodontics abides by all HIPAA patient privacy laws and regulations. You can download our patient forms below and fill them out at home to save time at our office!
Have Any Questions About Filling Out Your Dental Patient Forms?
Contact El Segundo Modern Dentistry & Orthodontics today by calling (424) 277-2671, and our friendly staff will be happy to answer any questions about patient forms.
