Simi Valley, CA 93065 (805) 317-4999 Request Appointment

COVID-19 Office Updates
Our office is now OPEN
Please call: (805) 317-4999 to schedule an appointment
We have set forth guidelines that surpass CDC recommendations to insure sterility and cleanliness. We ask that you wear a mask upon arrival, and keep to the social distancing protocols. Please bear with us as we take these measures for your safety and ours.

New Patient Forms

A patient filling out a form at Simi Hills Dental with the help of a receptionist.

The following forms are provided to our patients online for download. Please print and complete the forms and bring them to your appointment.

If you have questions about any of the paperwork, please give us a call at (805) 317-4999 and our staff will be happy to help you. Click on the button below to download our new patient and medical history forms.

New Patient and Medical/Dental History Form

Financial Policy Form

New Patient Forms

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