Patient Forms

New patient? Please download and fill out ALL the following forms :

New Patient's Form
Scan1.pdf
Adobe Acrobat document [80.4 KB]

Health History Form - Part 1
Scan20002.pdf
Adobe Acrobat document [456.4 KB]

Health History Form - Part 2
Scan20003.pdf
Adobe Acrobat document [413.0 KB]

Treatment Consent
Treatment Consent.pdf
Adobe Acrobat document [229.1 KB]

Visit Needs Checklist
Scan2.pdf
Adobe Acrobat document [502.2 KB]

Our Financial Policy
NEW FA (1).jpeg
JPG image [650.4 KB]

Privacy Notice

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.

Privacy Notice
notice_of_privacy_practices(1).pdf
Adobe Acrobat document [214.9 KB]

Ready to

Schedule?

(650) 701-1122

or use our online contact form.

Peninsula Dental Care

1122 Hopkins Ave

Redwood City, CA 94062

Fax: (650) 556-1122

Email:

info@peninsuladentalcare.com

Office Hours

Monday, Tuesday, Thursday

9:00am - 6:00pm

Fridays

7:00am - 4:00pm

Saturday, Sunday. Wednesday

CLOSED

Having a dental emergency?

We all know that dental emergencies can happpen anytime and therefore we want to be there for our patients should they need us. For a non life-threatening emergency, you can reach Dr. Petros after hours at (408) 644-0475 and will do our best to take care of you.

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